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Levels of RVE1 in patients were significantly lower compared to controls (median and IQR= 24.09, 15.7634.38 pg/mL vs 28.51, 20.7651.23 pg/mL)

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These insulin surges can cause low blood sugar (reactive hypoglycemia), which in turn can cause troublesome symptoms like lightheadedness, nervousness, anxiety , and fatigue

Junker Y, Zeissig S, Kim SJ, et al

Moreover, the regulatory profiles of key central metabolic activities involved in the regulation of the acetyl-CoA/CoA ratio, such as the TCA cycle, the glyoxylate shunt and the acetate metabolism were closely interrelated and exercised a control on the biotransformation efficiency [26, 30, 104] (Fig