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Similarly, the raw data for the psychosocial impact scale were scored as follows: never = 4, sometimes = 3, often = 2, and always = 1

doi:10.1136/ard-2023-224416

L-carnitine may raise the hepatic homogenate glucose levels possibly by increasing beta-oxidation and producing excess hepatic glucose via gluconeogenesis.[] However, some studies indicated that carnitine could have a positive effect on glucose metabolism via modifying and altering the genes expression that contributes to its metabolism such as enzymes of gluconeogenic, glycolytic, and insulin signaling pathway, and also by increasing the activity of pyruvate dehydrogenase, producing more acetyl-CoA and stimulating the Krebs cycle.[] Oxidative stress profile Oxidative stress is caused by an imbalance in the production of reactive oxygen species and the cell's own antioxidant defense, which may contribute to a number of diseases.[] Some studies showed that L-carnitine may be able to improve oxidative stress via affecting factors such as ox LDL-C, 4-HNE, NO2/NO3, TBARS, and MDA

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