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Catabolic states Clinical investigators have shown that IGF-I levels are often significantly altered in catabolic states, including the acute postoperative period[367], burn patients[368] and chronic catabolic illnesses, such as cystic fibrosis[369] and HIV with wasting[370]

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Importantly, even in the absence of overt clinical manifestations, CAA may elicit localized inflammatory responses, potentially mediated by the recruitment of monocytes and macrophages (Yamada, 2000)

Xu LT, Wang T, Fang KL, Zhao Y, Wang XN, Ren DM, et al

DHA can undergo irreversible hydrolysis to 2, 3-diketogulonic acid, if not reduced by DHAR