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Tumour necrosis factor-alpha (TNF-) suppresses insulin signalling [33], interleukin-6 (IL-6) directly induces inflammation or enhances the release of hepatic C-reactive protein [34], while interleukin-8 (IL-8) activates neutrophil granulocytes

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For instance, an 8-week double-blind controlled trial showed that when the subjects used a cream containing 2% L-carnitine daily and combined it with aerobic exercise three times a week, the average local fat thickness decreased by 12%-18%, and the proportion of fatty acid oxidation increased by approximately 15%-20%

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