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A proof of the dynamic balancing of carnitine homeostasis derives from the observation that, under regular diet, patients carrying defects of the carnitine biosynthesis enzymes, do not apparently display carnitine deficiency, because the reduced synthesis is compensated by carnitine dietary intake and increased renal reabsorption (El-Hattab and Scaglia, 2015)

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acetylation, methylation or glycosylation), transduce the information on the cell metabolic status, and modulate the activities of signaling proteins, enzymes, and transcriptional regulators 3