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. 2019 Jan 13;99(6):274–281. doi: 10.1111/iep.12299

Figure 5.

Figure 5

Metabolic reactions involved in ammonia detoxification to GLN in muscles resulting in enhanced BCAA catabolism, cataplerosis of α‐KG, mitochondrial dysfunction and ATP depletion. In addition, GLN synthesis from GLU catalysed by glutamine synthetase is the ATP consuming reaction. Clinical manifestations are fatigue and muscle wasting