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L-carnitine also ameliorates oxidative stress by reducing ROS production (75), decreasing hepatic malondialdehyde (MDA) content (59, 76), lowering 8-OHdG concentrations, and attenuating 4-hydroxynonenal (4-HNE) immunostaining intensity ( Octn2, Cpt1a, Cpt2, Acadm ) while increasing metabolites associated with TCA cycle, urea cycle, and antioxidant pathways (malate, citrulline) ( Beyond mitochondrial mechanisms, L-carnitine inhibits hepatocyte autophagy and apoptosis