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Secondary carnitine deficiency can be caused by increased losses, pharmacological therapy, a number of inherited metabolic disorders [38], poor diet or malabsorption of carnitine, from increased renal tubular loss of free carnitine (Fanconi syndrome), haemodialysis, peritoneal dialysis, or the increased excretion of acylcarnitines[39] with certain drugs

For immunostaining of MafA, PDX-1 and GLP-1R, the following antibodies were used as a primary antibody (MafA: ab264418 (1:500), PDX-1: CST 5679 (1:100), GLP-1R: DSHB Hybridoma Product Mab 7F38 (1:15.5)

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Follow-up visits : Continue cardiovascular examination, including heart rate and blood pressure