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Gut microbes can use carnitine and acylcarnitine as carbon sources, nitrogen sources, osmotic protectants or electron acceptors, but the gut microbiota cannot synthesize carnitine itself, and the mitochondrial function of acylcarnitine produced by carnitine palmitoyltransferase has not been observed in prokaryotes [230]

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Thirdly, protein restriction in humans (283) and rodents (84), particularly with concomitant high-carbohydrate dietary content (284), increases circulating FGF21