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Environmental factors, including diet and micronutrient availability, may influence disease penetrance and should therefore be considered when interpreting these findings

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Effects of L-Carnitine Supplementation on Serum Inflammatory Factors and Matrix Metalloproteinase Enzymes in Females with Knee Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Pilot Study

As with any observational study, residual confounding is possible, and continued evaluation across different agents and populations remains important