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The findings demonstrated that the ALCAR group experienced statistically significant improvements in musculoskeletal pain, depressive symptoms, and overall quality of life compared to the control group, with drastic reductions in both the Fibromyalgia Impact Questionnaire (FIQ) and Patient Health Questionnaire (PHQ-9) scores

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25 Similar variations have been observed in the reporting of total carnitine (26.6 1.18 to 57 2.3 mol/L), acetyl-l-carnitine (0.84 0.20 to 10.2 0.368 mol/L) and other carnitine concentrations

Moreover, GLP-1RA exendin-4 improves insulin resistance by directly inhibiting the activation of nuclear factor-kappa-B (NF-B) within the murine macrophage cell line RAW264.7 [88, 89]