L-Carnitine influences lactate metabolism, carbohydrate sparing, and fat oxidation during exercise
The covariates included age (modelled as a continuous variable using cubic splines with five knots at the 5th, 27.5th, 50th, 72.5th, and 95th centiles), sex, smoking status, body mass index, alcohol related disorders, and cohort entry year (2013-15, 2016-18, 2019-21)
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The mechanism is believed to involve the effect of GLP-1 receptor agonism on pancreatic function, though a direct causal relationship has not been firmly established across the class