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An overweight 4-year-old boy presents semi-comatose in the ER at 10AM. Plasma glucose, urea, and glutamic acid are abnormally low; acetoacetate is elevated; and lactate is normal. He is admitted to the ICU, where an inc in blood glucose was acheived by glucagon and alanine. which metabolic pathway is most likely deficient in this child?

A. hepatic GNG
b. skeletal muscle glycogenolysis
c. adipose tissue proteolysis
d. skeletal muscle proteolysis
e. hepatic glycogenolysis

dd

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dddddddddddddddddddd at last one that a answer rigth

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any explanation pls?

ddd,here there is no proteolysis in skeletal muscle hence low glutamate and urea,gluconeogenesis is normal when alanine is given to the boy,breakdown of TG present,hence high acetoacetate,glycogenolysis is not affected as depicted by the normal lactate levels.
Main substrate for gluconeogenesis is alanine(needs protein breakdown in the muscle during post absorptive states).

Why not C?

Is there any relationship between elevated acetoacetate and lipid metabolism? beta-oxylation of fatty acid?