Furthermore, since PDK4 expression is upregulated in cancer cachexia in mice, as shown in this study (Fig. 3) and in our previous study (71), as well as in rats (95), we hypothesized that the contribution of glycolytic reactions to unidirectional ATP synthesis flux is negligible, since PDK4 inhibits the pyruvate dehydrogenase complex, which is involved in controlling the use of glucose-linked substrates as sources of oxidative energy via glycolysis (96). The gene discussed is PDK4; the disease is cancer.