Skeletal muscle dysfunction is typically characterized by reduced muscle strength, reduced muscle endurance, impaired muscle oxidative capacity (as shown by reduced activity of the enzymes citrate synthase and hydroxyacetyl-CoA dehydrogenase, and a shift toward a glycolytic fiber type distribution (low fraction of Type I fibers). These changes result in reduced skeletal muscle endurance, increased fatigability, a lowering of the lactate threshold, and increased ventilatory requirements during exercise.

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