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5.2 Disorders of mitochondrial long-chain fatty acid oxidation 5.2.1 Very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency Clinical presentation Patients diagnosed with VLCAD deficiency (OMIM 201475) can suffer from hepatic, cardiac and muscular symptoms that can appear in infancy, but also later during adolescence or adulthood

Additionally, lifestyle factors ( sleep, training load, stress ) can modulate the perception of energy

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Nevertheless, a decrease in L-carnitine levels associated with intense muscular exercise was not observed