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Human metabolism is a key component of the basic science knowledge that underlies the practice of medicine and allied health professions. It is fundamental to understanding how the body adapts to physiologic stress, how defects in metabolism result in disease, and why data from the clinical chemistry laboratory are useful to diagnose disease and monitor the efficacy of treatment. Over the more than three decades that each of the authors has been teaching biochemistry to medical students, we have found students increasingly overwhelmed with details that tend to obscure rather than elucidate principles of human metabolism. Our main aim in writing this book was to provide students in the health professions with a concise resource that will help them understand and appreciate the functions, constituent reactions, and regulatory aspects of the core pathways that constitute human metabolism and which are responsible for maintaining homeostasis
and well-being in humans. We have tried to accomplish this by emphasizing function, regulation, and disease processes, while minimizing discussion of reaction mechanisms and details of enzyme structure. Each chapter is organized in a consistent manner beginning with an explanation of the main functions of the pathway under discussion. Next comes a brief accounting of the cells, tissues, and organs in which the pathway is expressed and the conditions under which the normal function of the pathway is especially important. The bulk of each chapter is devoted to the reactions that account for the function of the pathway, with emphasis on key steps in the pathway. The next section of each chapter discusses the ways in which the activity of the pathway is regulated by hormones, genetic factors, or changes in the intracellular concentration of key metabolites. Each
chapter concludes with a discussion of the more common and illustrative diseases that result from defects in or derangements of regulation of the pathway.
