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In addition, exposure to sweeteners has been shown to alter fermentation profiles and metabolism in vitro, indicating a connection between sweetener exposure and modifications in both microbiota composition and microbial metabolic processes (Vamanu et al, 2019)

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As the disease progresses to stage 3, systemic hyperphosphatemia typically arises, further exacerbating systemic inflammation and vascular calcification, and consequently accelerating the process of early vascular aging (Voelkl et al., 2018)