Preoperative hypoalbuminemia has long been considered a classic risk factor for poor surgical outcomes (69)
It may therefore seem somewhat enigmatic that the activity of pyruvate recycling in the brain as well as in cultured brain cells appears relatively modest ( Figure 4 Figure 5 Figure 6 Cellular distribution of glutamine transporters As a consequence of the astrocytic localization of de novo synthesis of glutamine, a mechanism must exist which can mediate transport of glutamine out of the astrocytes and into glutamatergic and GABAergic neurons, respectively
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Stephens FB, Wall BT, Marimuthu K, Shannon CE, ConstantinTeodosiu D, Macdonald IA, Greenhaff PL: Skeletal muscle carnitine loading increases energy expenditure, modulates fuel metabolism gene networks and prevents body fat accumulation in humans
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Excess body fat, particularly visceral fat, generates pro-inflammatory cytokines that cross the blood-brain barrier and disrupt normal neurotransmission
