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In the Commentary, a number of recently published clinical trials are referenced

Secondary carnitine deficiency is more common and is associated with help problems such as: Liver disease End-stage renal disease A digestive disease that causes poor absorption Malnutrition Mitochondrial disease Certain metabolic disorders Certain medicines, such as valproate L-carnitine in review There are both animal studies and well-organized (randomized double-blind placebo-controlled trial) in human subjects investigating the role of l-carnitine treatment for exercise improvement, physical performance, and recovery with promising results

LPL is a glycoprotein that is synthesized and secreted in several tissues (e.g., adipose tissue, skeletal muscle, cardiac muscle, and macrophages)