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Acetyl-CoA is also an allosteric activator of pyruvate carboxylase that catalyzes the gluconeogenesis pathway which is active during catabolic states such as fasting.[6][15][16] In carnitine deficient states, LCFAs cannot be effectively transported to the mitochondria matrix for oxidation and subsequent utilization in Krebs cycle and ketone body production

In another study, Tsai et al

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95% CI, 0.38 to 1.16