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Accordingly, enzymes required for mitochondrial transport and metabolism of fatty acids and glucose, including carnitine palmitoyltransferase 1 (CPT1b), CPT2, glucose transporters (GLUT1, GLUT4), mitochondrial pyruvate carrier, and pyruvate dehydrogenase are expressed at elevated levels in brown adipocytes [23]

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This tells the payer that this is a medically necessary procedure.