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Alcoholic fatty liver disease is another major cause of fatty liver disease, for which carnitine supplementation may also be beneficial for improvement (77)

Intercostal muscle training mostly adopts exercise that promote upper body activities, such as chest expansion, rotation, swimming and various ball games (Zhou and Sun, 2021)

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Additionally, a profound decline in FBS, insulin, and HOMA-IR ( p = 0.014, 0.051, 0.024, respectively) and an increment in QUICKI ( p = 0.019) were observed in the L-carnitine + synbiotic group compared with the L-carnitine + placebo group post-intervention, which remained significant after adjustment for the baseline levels and possible confounding factors