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Oxidative stress is the primary driver of DNA fragmentation
Linearity plot for D-Carnitine
In summary, d-carnitine cannot be physiologically used, such that the high serum FA levels cannot be lowered, because they cannot enter mitochondria for oxidation, resulting in lipotoxicity
Cardiac and skeletal muscle, harboring the highest concentrations, cannot synthesize carnitine and so must acquire carnitine from plasma
