Figure 5.

Skeletal muscle and liver metabolic cross-talk in IUGR fetuses. The schematic outlines the tissue metabolism outcomes due to mitochondrial adaptation in the skeletal muscle and liver of IUGR fetuses, created using BioRender.com. Lower responses (red) and greater responses (blue) are shown for IUGR mitochondria and whole tissue. The IUGR skeletal muscle is thought to be in a low energy, slow growing state in which substrate oxidation rates are lower. The adaptation by the IUGR skeletal muscle is thought to conserve oxygen, but also increase Cori (lactate) and Cahill (alanine) cycling. Conversely, the IUGR liver is proposed to use pyruvate supplemented with ammoniagenic amino acids to sustain increased glucose production. However, in the process of ammoniagenic amino acid degradation, this may lead to increased release of ammonia.