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Accumulation of reactive fatty acids leads to mitochondria -oxidation imbalance that subsequently contributes to liver inflammatory injury and increased expression of proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor- (TNF-), MCP-1, and IL-1, that further exacerbate SHBG depletion [52]

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The study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the institutional review board

Furthermore, L-carnitine has been also described as a final electron acceptor under anaerobic conditions in the presence of additional carbon and nitrogen sources (Seim et al., 1982