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Supplement: Nutritional Consequences of Critical Illness Myopathies

Metabolic Consequences of Muscle Disuse Atrophy^1,2

Department of Surgery, University of Medicine and Dentistry of New Jersey, School of Osteopathic Medicine, Stratford, NJ 08084 and ^* U.S. Army Institute of Surgical Research, Fort Sam Houston, TX 78234-6315

³To whom correspondence should be addressed. E-mail: tpstein{at}umdnj.edu.

In response to decreased usage, skeletal muscle undergoes an adaptive reductive remodeling. This adaptive response has been found with disuse during human spaceflight, rat spaceflight, rat hind-limb unloading, bed rest, and aging. The reductive remodeling of skeletal muscle with disuse is largely independent of the reason for the disuse. The process involves more than a transition from slow to fast myosin fiber types. There are associated metabolic changes including a fuel shift toward glycolysis, decreased capacity for fat oxidation, and energy substrate accumulation in the atrophied muscles. Glycolysis is very effective for high-intensity short-duration acute activities, but if sustained output is needed, an energy profile where fat use is favored rather than compromised is desirable. For astronauts, there is a need to maintain as much functional capacity as possible during spaceflight for extravehicular activities. The shift toward increased activity of the glycolytic enzymes in atrophied muscle is accommodated by an increase in gluconeogenic capacity in the liver.

KEY WORDS: • muscle atrophy • liver • space flight • microarrays • gluconeogenesis

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