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He X, Gao X, Guo Y, et al

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One explanation comes from the medication itself

PIO was the first antihyperglycemic medication that demonstrated beneficial liver effects in a small RCT, which analyzed data from 55 individuals with prediabetes/diabetes and biopsy-proven NASH [48]

In the words of the Stephens Group in an overall review of their work: the apparent reduction in glycolytic flux and carbohydrate oxidation (decreased PDC activity and lactate content, and increased glycogen accumulation), in the face of high carbohydrate availability, could have been caused by a carnitine-mediated increase in skeletal muscle long-chain fatty acid oxidation, i.e

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