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Carnitine levels are reduced in patients suffering Gram-negative sepsis and urinary loss of carnitine is proportional to the degree of injury [96]
Moreover, it appears that it is the membrane-bound form of the enzyme, on sites such as the luminal surface of capillary endothelial cells, which is more important for GLP-1 degradation than the circulating (soluble) enzyme (74, 75), questioning the relevance of any association between the plasma activity per se and glycaemic control, since it is unclear whether changes in soluble DPP-4 activity in the circulation accurately reflect any changes in total DPP-4 activity