The formation of acetylcarnitine may serve as a mitochondrial rescue mechanism to prevent the development of metabolic inflexibility and type 2 diabetes. We here used a novel magnetic resonance spectroscopy protocol, using long echo times, to determine acetylcarnitine concentrations in skeletal muscle in vivo. Carnitine supplementation enhanced the increase in acetylcarnitine concentration in resting muscle over the day as well as the capacity to form acetylcarnitine with exercise. Furthermore, carnitine supplementation completely restored metabolic flexibility suggesting that carnitine supplementation may be an interesting aid in improving disturbed metabolism in subjects prone to develop type 2 diabetes mellitus.
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