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Abstract
To the Editor: Ruggenenti et al1 report that oral administration of acetyl-l-carnitine results in a substantial, sustained, and simultaneous improvement in insulin sensitivity and blood pressure in insulin-resistant individuals. Carnitine is essential for mitochondrial import and subsequent β-oxidation of long-chain fatty acids and in the sequestration and mitochondrial export of inhibitory acetyl-coenzyme A units as acetyl-carnitine, actions that favor glucose oxidation. Mitochondrial dysfunction associated with incomplete β-oxidation and accumulation of intramyocellular lipids may contribute …
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