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Here, the greatest amount of carnitine is stored and also used up at the same time

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In particular, skeletal muscle acts as a depot for systemically absorbed LA, which may account for the clinical risk of LAST in diminutive patients whose muscle mass is substantially less than normal

Carnitine is then involved in the regulation of the acyl-CoA/CoA balance that has important consequences in the modulation of carbohydrate metabolism, lipid biosynthesis and degradation, and gene expression (Figure 1