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It is known that NAFLD is associated with an imbalance in a variety of metabolic networks, among which abnormal lipid metabolism is the core pathological metabolic process ( An important mechanism by which carnitine improves IR is enhancing the oxidation of mitochondrial long-chain acyl-CoAs (Figure 2) ( Other possible mechanisms to improve insulin sensitivity in NAFLD reported in the literature include the regulation of the acetyl-CoA/CoA ratio in mitochondria, modulation of the pyruvate dehydrogenase complex (PDHC) activity, altering the expression of glycolytic and gluconeogenic enzymes as well as the expression of genes associated with the insulin signaling cascade, and stimulation of the insulin-like growth factor-1 (IGF-1) axis and IGF-1 signaling cascade ( Role of Carnitine in NAFLD Progression and Development of Associated Diseases The liver is the main organ responsible for detoxification and metabolism of various compounds that produce reactive oxygen species (ROS)