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In the first trimester, 92% of the detected miRNAs in plasma exosomes from GDM patients were significantly elevated compared to those in normal pregnancies, while no significant differences were observed between the two groups in the second trimester, suggesting that the first trimester is the optimal time window for exosomal miRNA detection

Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy)