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Anaplerotic effect of triheptanoin metabolism. Fatty acid oxidation provides reducing equivalents directly to the electron transport chain and supplies substrates to the tricarboxylic acid (TCA) cycle. Oxidation of even chain fats produces only acetyl-CoA and the TCA cycle can ultimately become depleted of odd chain carbon species with excessive catabolism in patients with LC-FAODs. In contrast, triheptanoin provides both acetyl-CoA and propionyl-CoA, preserving TCA cycle function.
