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Using genetic in vivo models, the authors showed that deacetylation of HMGCS2 by sirtuin 3 (SIRT3), which belongs to the deacetylase/ADP-ribosylase family of sirtuins, increases HMGCS2 enzyme activity

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L-carnitine is widely used by athletes and gym-goers for its role in energy metabolism

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Acute Presentation Lethargy, altered mental status Nausea, vomiting Hepatomegaly Laboratory Findings Hypoglycemia Metabolic acidosis with anion gap Hyperammonemia There are two types of presentation, depending on the severity of the metabolic defect

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