DMD and Duchenne muscular dystrophy: DMD is a lethal disease caused by the absence of dystrophin resulting in substitution of muscle mass by adipose tissue.26, 27 Downstream effects of lack of dystrophin have largely been studied in muscles samples from patients and animal models enabling the identification of morphological alterations and pathological pathways behind the clinical presentation.28, 29, 30, 31 Clear metabolic alterations have been described in DMD muscle tissue affecting the energy metabolism (eg glycolysis) and mitochondrial alterations (eg the tricarboxylic acid cycle and electron transport chain).