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Ketogenesis occurs predominantly within the hepatic mitochondria, with carnitine palmitoyl transferase I (CPT-1) acting as the critical rate-limiting enzyme for mitochondrial fatty acid import (Figure 1)

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Moreover, synbiotics have been reported to improve gut integrity via SCFA production, by which inhibiting the TLR4LPS complex-triggered proinflammatory cascade, hampering proinflammatory cytokine signaling pathways, such as nuclear factor kappa B (NF-B), thereby decreasing insulin resistance (31, 34)