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It was not until the development of an in-vitro carnitine uptake assay on cultured fibroblast, a clear-cut definitive diagnosis of CUD could be made.2 However, in-vitro functional assay has many limitations and the most obvious one is the unavailability of living fibroblast as fibroblast culture from skin biopsy is not a routine investigation that is readily available

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examined the effects of KD for 6 days on hepatic steatosis and found reduced liver fat content and hepatic insulin resistance in NAFLD patients (Luukkonen et al., 2020)

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