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The impact of prioritising early aggressive therapy to induce remission is unclear

Specifically, elevated levels of medium- and long-chain acylcarnitines correlate strongly with declining renal function and increasing proteinuria, while late-stage disease is marked by depletion of free carnitine, reflecting progressive metabolic dysregulation [17,18,19]

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The same held true for people with diabetes in an earlier meta-analysis of 128,505 participants with a mean follow-up of 8.5 years