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Carnitine acetyltransferase (CrAT) can act as safety valve to catalyze the reversible transfer of acetyl groups between acetyl-CoA and acetylcarnitine, promoting the combination of excess acyl groups with carnitine, increasing the membrane permeability of these products and thus removing them from the mitochondria, allowing acylcarnitine to be formed in the mitochondrial matrix and exported to the plasma [7]

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Furthermore, the exclusion of patients with CKD and using BMI in the PSM excluded and accounted for other indications for the use of GLP-1 RAs and ensured that their use in our patient population was for glycemic control