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The mechanism underlying carnitine's anti-aging effects involves multiple pathways: restoration of mitochondrial cardiolipin content and membrane integrity, enhancement of fatty acid oxidation to reduce lipotoxic stress, reduction of protein oxidation and carbonyl formation, improvement of calcium homeostasis and cellular signaling, and activation of stress resistance pathways that promote cellular resilience

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In addition, patients with severe hepatic dysfunction (hepatic decompensation, cirrhosis, or other chronic liver diseases) and with elevated (five times more the upper limit of normal range) serum ALT or aspartate AST were not included

Therefore, postnatal L-carnitine deficiency may lead to impaired fatty acid oxidation, resulting in clinical manifestations of hypoglycemia, hypothermia, acidosis and infection