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Further longer term, larger scale and preferably multi-center studies are recommended to explore additional benefits, meanwhile it is prudent to advise L-carnitine supplementation for such patients

In certain embodiments, a sterically hindered thiol such as t-BuSH is present in the reaction in a stoichiometric ratio relative to the amino acid comprising conjugation partner of from about 100:1 to 0.05:1, for example about 80:1, about 40:1, or about 3:1

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Regional prevalence rates are currently highest in the Middle East (32%) and South America (30%) and lowest in Africa (13%), but prevalence rates are even higher in specific subpopulations such as severely obese (90%) and patients with type 2 diabetes (76%) [1]