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1 Chapter 1Figure 1.1 Rates of energy intake and output for a motor vehicle. The rate of intake (top ...Figure 1.2 Rates of energy intake and output for a person during a typical day. The rate o...Figure 1.3 (a) Three-dimensional structure of the methane molecule and (b) the molecular s...Figure 1.4 Chemical structures of some lipids. A typical saturated fatty acid (palmitic ac...Figure 1.5 Structure of biological membranes in mammalian cells. Cell membranes and intrac...Figure 1.6 Cholesterol and a typical cholesteryl ester (cholesteryl oleate). In the struct...Figure 1.7 Some simple sugars and disaccharides. Glucose and fructose are shown in their ‘...Figure 1.8 Structure of glycogen. Left-hand side: each circle in the upper diagram represe...Figure 1.9 Pictures of the molecular shapes of different fatty acids. (a) saturated fatty ...Figure 1.10 Comparison of fat and carbohydrate as fuel sources. Raw potatoes (right) are hy...Figure 1.11 Structure of an amino acid. At physiological pH (7.4) the carboxyl group is ion...Figure 1.12 Catabolism and anabolism.Figure 1.13 Overall metabolic energy flux. The three energy groups (fats, carbohydrates, pr...Figure 1.14 Pathways of glucose metabolism inside the cell. The pathways of glucose (carboh...Figure 1.15 Lactate and ethanol metabolism. Glycolysis produces NADH from NAD+. (a) In aero...Figure 1.16 Pathways of lipid metabolism in the cell. Synthesis of fatty acids from acetyl-...Figure 1.17 Lipid metabolism pathways. Importance of lipolysis and esterification pathways ...Figure 1.18 Parallel between soap manufacture (saponification) and fat mobilisation. In sap...Figure 1.19 Metabolism of amino acids. To be metabolised, amino acids must first be deamina...Figure 1.20 Transamination reactions. Transamination involves the transfer of an amino grou...Figure 1.21 Deamination of amino acids. By linking transamination reactions to oxidative de...Figure 1.22 Urea cycle. One nitrogen atom enters the cycle as an ammonium ion from glutamat...Figure 1.23 Metabolism of the carbon skeletons of amino acids following their deamination. ...

2 Chapter 2Figure 2.2.1 Figure 2.1 Sodium-linked active transport. By co-transport with Na+ ions, substance X may ...Figure 2.2 GLUT4 recruitment to the cell membrane. There is an intracellular pool of GLUT4...Figure 2.3 Different methods for achieving changes in metabolic flux within a cell. A hypo...Figure 2.5.1 Figure 2.4 Different stages at which the amount of a protein present in a cell may be cont...Figure 2.5 Operation of the circadian clock at a cellular level. The proteins CLOCK (circa...Figure 2.6 Glucose control of expression of lipogenic genes. Glucose increases gene expres...Figure 2.7 The PPAR system. The ligand for the PPAR (a fatty acid, or a fatty acid derivat...Figure 2.8 The SREBP system. The full-length SREBP protein is located in the endoplasmic r...

3 Chapter 3Figure 3.1 The circulatory system. Oxygenated blood from the lungs returns in the pulmonar...Figure 3.2 Diffusion of chemical substances through the interstitial fluid. A typical tiss...Figure 3.3.1 Synthesis and breakdown of cAMPFigure 3.3.2 PI3K, phosphatidylinositol-3-kinase; PLC, phospholipase C....Figure 3.4.1 Signal chain for regulation of many metabolic processes by insulin. Insulin bin...Figure 3.4.2 Signal chain for stimulation of glycogen breakdown by adrenaline (or noradrenal...Figure 3.4.3 Signal chain for control of hormone-sensitive lipase (HSL) in adipocytes. HSL i...

4 Chapter 4Figure 4.1 Anatomy of the digestive tract and associated organs.Figure 4.2 Control of gastric acid secretion. Plus signs indicate stimulation or activatio...Figure 4.3 Structure of a villus of the small intestine. One of the absorptive cells (ente...Figure 4.4 Vessels carrying the products of digestion away from the small intestine. Subst...Figure 4.2.1 Figure 4.5 Lipid digestion and absorption in the small intestine. Fatty acids and choleste...Figure 4.6 Hormonal regulation of the secretion of digestive juices. Gastrin stimulates hy...Figure 4.7 Absorption of monosaccharides from the intestine. Monosaccharides enter the ent...Figure 4.8 Esterification pathways for the formation of triacylglycerol. The monoacylglyce...Figure 4.9 Cholesterol absorption. Niemann-Pick C1-like protein-1 (NPC1L1), expressed at t...

5 Chapter 5Figure 5.1 Arrangement of hepatocytes in liver lobules. In a cross-section of the liver, t...Figure 5.2 Outline of glucose metabolism and its hormonal regulation in the liver. Dashed ...Figure 5.1.1 Figure 5.2.1 Figure 5.3.1 Pathways around pyruvate carboxylase (PC) and phosphoenolpyruvate carboxykinase...Figure 5.3 The pentose phosphate pathway and its links with lipogenesis. G 6-P, glucose 6-...Figure 5.4 Overview of fatty acid metabolism in the liver. Fatty acids cross the hepatocyt...Figure 5.5 The pathway of ketone body formation from acetyl-CoA (ketogenesis). This is loc...Figure 5.4.1 Figure 5.6 Outline of amino acid metabolism in the liver. Liver contains the enzymes of gl...Figure 5.7 Appearance of brown and white adipose tissue. Left, white adipose tissue under ...Figure 5.8 Overview of fatty acid and glucose metabolism in white adipose tissue. The body...Figure 5.9 The action of lipoprotein lipase in white adipose tissue. Top panel: Lipoprotei...Figure 5.10 The intracellular pathway of lipolysis in adipocytes. Triacylglycerol (TAG) in ...Figure 5.11 Suppression of fat mobilisation by insulin. Top panel: Insulin restrains fat mo...Figure 5.12 Uncoupling of respiration in brown adipose tissue (and potentially other tissue...Figure 5.13 Human brown adipose tissue depots. Brown adipose tissue (BAT) depots around the...Figure 5.14 Structural organisation of skeletal muscle. One cell is a muscle fibre. The who...Figure 5.15 The creatine kinase reaction in muscle. The reaction is referred to as the Lohm...Figure 5.16 Fibre-type composition of leg muscles in athletes. Different types of muscle fi...Figure 5.17 ATP generation in skeletal muscle. Only major pathways are shown: each arrow ma...Figure 5.7.1 Figure 5.18 (a) Section of kidney and (b) schematic view of energy metabolism in different ...Figure 5.19 The endothelium, a smooth single-celled lining of blood vessels.Figure 5.20 Generation of nitric oxide (NO) from arginine in endothelial cells leads to rel...Figure 5.21 Amino acid metabolism in enterocytes. In the fed state the enterocytes oxidise ...

6 Chapter 6Figure 6.1 The location of endocrine glands involved in energy metabolism. The thymus is s...Figure 6.2 Islets of Langerhans in the pancreas. The pancreatic tissue has been immunostai...Figure 6.3 Synthesis of insulin. Insulin is first synthesised as one long polypeptide, pre...Figure 6.4 Glucose stimulation of insulin secretion in the pancreatic β-cell. Glucose ente...Figure 6.5 Dose–response curve for the effects of glucose concentration on the secretion o...Figure 6.6 Pituitary hormones and their target organs.Figure 6.7 The anatomy of the thyroid gland.Figure 6.8 Biosynthesis of the thyroid hormones. Thyroxine (T4) and triiodothyronine (T3) ...Figure 6.9 The anatomy of the adrenal glands.Figure 6.10 Biosynthesis of the catecholamines. Noradrenaline is a neurotransmitter, releas...Figure 6.11 Propranolol (a β-adrenergic blocker) inhibits lipolysis in response to exercise...Figure 6.12 The leptin system and regulation of fat stores. Leptin is produced in, and secr...Figure 6.13 The idea of ‘incretins’ (gut-derived hormones that augment insulin secretion). ...Figure 6.14 Basic structure of a nerve cell (neurone).Figure 6.15 The structures of two important neurotransmitters, acetylcholine, and noradrena...Figure 6.1.1 Figure 6.2.1 Figure 6.16 The human brain and its main components.Figure 6.17 The neuromuscular junction.Figure 6.18 Types of neurotransmission in the central and peripheral nervous systems. ACh, ...Figure 6.19 Plasma glucagon, adrenaline, and noradrenaline concentrations in response to ra...

7 Chapter 7Figure 7.1 Relative constancy of blood glucose concentrations during a typical day, compar...Figure 7.2 An analogy for metabolic regulation. The temperature in a thermostatically cont...Figure 7.3 The pattern of glucose metabolism after an overnight fast. The numbers are appr...Figure 7.4 Concentrations of insulin, glucose, and lactate in blood after an overnight fas...Figure 7.5 Rates of glucose release from liver, from exogenous (dietary) and endogenous (g...Figure 7.6 Increases in liver and skeletal muscle glycogen after a single meal in normal s...Figure 7.7 The pattern of glucose metabolism after a carbohydrate breakfast. The direct pa...Figure 7.8 Plasma non-esterified fatty acid (NEFA) concentrations after an overnight fast ...Figure 7.9 The pattern of non-esterified fatty acid (NEFA) metabolism after an overnight f...Figure 7.10 The milky appearance of blood plasma (right) after a fatty meal, compared with ...Figure 7.11 Triacylglycerol concentrations in plasma after a meal. The figure shows concent...Figure 7.12 The pattern of plasma triacylglycerol metabolism after a breakfast containing b...Figure 7.13 Overview of protein and amino acid turnover in the body. We eat (very approxima...Figure 7.14 The typical pattern of amino acid metabolism in different tissues. The diagram ...Figure 7.15 The reactions that synthesise (glutamine synthetase) and break down (glutaminas...Figure 7.16 Major amino acids interconversions in muscle. (Adipose tissue and brain may be ...Figure 7.17 Major pathways for amino acid flow between tissues. The major sites of amino ac...Figure 7.18 The intestinal-renal pathway. Enterocytes consume large amounts of glutamine (s...Figure 7.19 Overall control of protein synthesis and breakdown in muscle (and other tissues...Figure 7.3.1 Source: modified from Frayn, K. N. & Evans, R. D. (in press) Oxford Textbook of...Figure 7.20 The glucose–alanine cycle operates in concert with the Cori (glucose–lactate) c...Figure 7.21 Blood flow through adipose tissue and forearm muscle during a typical day with ...Figure 7.22 Increasing fat storage with successive meals during a typical day with three me...

8 Chapter 8Figure 8.1 Concentrations of ATP and of phosphocreatine (PCr) in Type II fibres in human m...Figure 8.4.1 Figure 8.2 Coordinated regulation of glycogenolysis and contraction by Ca2+ ions in skelet...Figure 8.5.1 Source: based on Newsholme, E. A., & Leech, A. R. (1983) Biochemistry for the M...Figure 8.4 Relationship between initial glycogen concentration in the quadriceps muscle an...Figure 8.5 Schematic drawing of the distribution of blood flow between various organs and ...Figure 8.6 Plasma concentrations of cortisol (top panel) and growth hormone (bottom panel)...Figure 8.7 Plasma glucose (top panel) and insulin (lower panel) concentrations during aero...Figure 8.8 Coordination of metabolism by the nervous system during endurance exercise. Adr...Figure 8.9 Glycogen concentrations in leg muscle after one-legged exercise (bicycling on a...Figure 8.10 Plasma triacylglycerol (TAG) concentrations after a high-fat test meal on two o...Figure 8.11 Offspring and maternal energy requirements in humans. Red circles represent foe...Figure 8.12 Fuel disposition in the developing foetus. The foetus requires all three nutrit...

9 Chapter 9Figure 9.1 The phases of starvation, assessed from the point of view of glucose metabolism...Figure 9.2 Liver glycogen concentrations in normal human volunteers, after overnight fast,...Figure 9.3 Rate of urinary nitrogen excretion in five obese subjects during starvation. So...Figure 9.4 Serum concentrations of triiodothyronine (T3) and reverse triiodothyronine (rev...Figure 9.5 Concentrations of non-esterified fatty acids (NEFAs) and ketone bodies (the sum...Figure 9.6 Major fuel flows in prolonged starvation. Protein (especially that in muscle) a...Figure 9.7 Urinary nitrogen, phosphorus and sulphur excretion following major trauma. Sour...Figure 9.8 Phases of metabolic change following acute injury, such as trauma. The ‘ebb’ ph...Figure 9.9 Pattern of alteration of net nitrogen excretion and resting energy expenditure ...Figure 9.10 Metabolic response to severe burn injury. Skin as injured tissue is both the or...Figure 9.11 Interconnection of hormonal (both endocrine and cytokine) changes with immune s...Figure 9.12 Changes associated with severe injury-sepsis and critical illness. The vertical...Figure 9.13 The Warburg effect. Normal cells, when provided with adequate oxygen, mostly ox...Figure 9.14 Altered metabolic pathways in cancer cells. Metabolism in tumour cells is direc...Figure 9.15 Cancer cachexia. Characteristic loss of muscle tissue mass, with weakness, but ...Figure 9.16 Effects of cancer growth on host metabolism and the aetiology of cancer cachexi...

10 Chapter 10Figure 10.1 A typical lipoprotein particle.Figure 10.2 The exogenous pathway of lipoprotein metabolism. Apo, apolipoprotein; FA, fatty...Figure 10.3 The endogenous pathway of lipoprotein metabolism. Particles may undergo several...Figure 10.3.1 Figure 10.4 HDL metabolism. Pre-β HDL is apolipoprotein AI (APOAI) associated with some pho...Figure 10.5 Forward and reverse cholesterol transport. Cholesterol is secreted by the liver...Figure 10.6 Relationship between risk of death from cardiovascular disease (coronary heart ...Figure 10.7 Lowering of cardiovascular disease with reduction in serum cholesterol. The dat...Figure 10.6-1 CETP, cholesteryl ester transfer protein (Section 10.2.3.2); TAG, triacylglycer...Figure 10.8 Impaired postprandial triacylglycerol metabolism in patients with coronary hear...

11 Chapter 11Figure 11.1.1 Summary of central pathways regulating appetite.Figure 11.1 Relationship between serum leptin concentration and percentage body fat in 179 ...Figure 11.2 Growth of a child with leptin deficiency due to a mutation in the leptin gene. ...Figure 11.3 Antoine Lavoisier measuring the O2 consumption of his assistant, Séguin. The pi...Figure 11.3.1 Data for the example are reproduced from Garrow, J. S. (1988) Obesity and Relat...Figure 11.4 Components of energy expenditure. A typical 24-hour energy expenditure of 10 00...Figure 11.5 Relationship between body fat content and body weight in a series of 104 women....Figure 11.6 Relationship between metabolic rate and fat-free mass (FFM; a measure of lean b...Figure 11.7 Insulin resistance in obese men. Plasma glucose and insulin concentrations are ...

12 Chapter 12Figure 12.1 A sufferer from Type 1 diabetes mellitus in the early days of insulin therapy, ...Figure 12.2 Typical plasma glucose and insulin responses to a carbohydrate load in Type 2 d...Figure 12.1.1 Redrawn from Felber, J. -P., Acheson, K. J., & Tappy, L. (1993) From Obesity to...Figure 12.3 The metabolic pattern in untreated Type 1 diabetes. Pathways accelerated by ins...Figure 12.4 Twenty-four-hour profiles of plasma glucose concentration in non-diabetic subje...Figure 12.5 Twenty-four-hour profiles of plasma non-esterified fatty acid (NEFA) concentrat...Figure 12.6 Plasma insulin concentrations in non-diabetic subjects and people with Type 1 d...Figure 12.7 Non-enzymatic glycation of proteins. A sugar molecule in its straight-chain, al...Figure 12.8 The polyol pathway for production and further metabolism of sorbitol. The enzym...

Human Metabolism

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