Declines in muscle protein synthesis are a primary metabolic feature of post-operative catabolism: A systematic review and meta-analysis

Rationale: Elective surgery induces skeletal muscle wasting that must occur through an imbalance between muscle protein synthesis (MPS) and muscle protein breakdown (MPB)[1]. However, due to methodological inconsistencies between stable isotope arterio-venous whole body protein measures and those that assess direct isotope incorporation into muscle; the predominant factor driving this imbalance is unclear.