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In patients with baseline normal ammonia levels, the NIRS data of l-carnitine group (n = 31) at 8 weeks of treatment were significantly better than that of the control group (n = 25) (0.11 0.09 vs
The lack of central carbon and nitrogen catabolism not only leads to energy deficiency but also reduces the supply of the main metabolite anabolic precursors such as pyruvate, acetyl-CoA, glucose-6-phosphate, and erythrose 4-phosphate used for biomass biosynthesis 21
In this context, the adoption of VLCKD is advised by the Italian Society of Endocrinology (SIE) for several obesity-related diseases, including hypertension, dyslipidemia, and type 2 diabetes mellitus [2]
