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Role in fatty acid metabolism Carnitine transports long-chain acyl groups from fatty acids into the mitochondrial matrix, so that they can be broken down through beta-oxidation to acetate to obtain usable energy via the citric acid cycle

Metabolic decompensation: usually occurs in infants aged 3 to 24 months, manifested by hypoglycemic coma, feeding difficulties, irritability, lethargy, hepatomegaly, elevated liver enzymes, and elevated transaminases

Future translational efforts should pursue several directions: first, conducting deep-phenotyping trials in biopsy-confirmed MASH patients, using positron emission tomography to quantify hepatic glucose uptake and correlating these findings with intrahepatic insulin signaling (e.g., p-AKT)