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JIMD Rep 2012;3:17-23
Fifth, due to lack of reported data, we could not analyze the dietary patterns, medication usage, gut microbiome profiles, L-carnitine bioavailability, or skeletal muscle carnitine content of the patients included in this meta-analysis, which may have had differential effects on the metabolism of L-carnitine

Garone C, Garcia-Diaz B, Emmanuele V et al

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Elevated plasma homocysteine levels are associated with impaired peripheral microvascular vasomotor response