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1a) can be subdivided into a reductive half-reaction (electrons flow from NADPH to the enzyme) and an oxidative half-reaction (electrons from the enzyme are transferred to the oxidizing substrates) 17

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Besides an increased homocysteine export from tissues into plasma that may be regulated by a reduced-homocysteine carrier (Blom, 2000), hyperhomocysteinemia can result from reduced renal function, which may have a central role in plasma homocysteine clearance, and from chronic hepatic insufficiency