Figure 5 (IMAGE) Impact Journals LLC Caption Late onset metabolomic changes. (A) Carnitine decreased significantly from T1 to T8 (p = 9.30E-04, adjusted for multiple testing) and propionyl carnitine decreased to a slighter extent (p = 1.64E-04). (B) Highly dynamic alterations in lactate concentrations. Lactate concentrations decreased within the anesthetic period and increased to an even greater extent in the consecutive joint period (p = 2.65E-03). (C) Hydroxyproline (marker for collagen turnover) significantly decreased after beginning of surgical procedures (p = 3.05E-03). (D) Triglyceride concentrations decreased in perioperative period. Triacylglyceride 18:1_34:1 as the most abundant one is presented exemplarily. The ratio of [triacylglycerides]/|fatty acids] serves as an indicator for synthesis of triacylglycerides and decreased, symbolizing a degradation of triacylglycerides (p = 8.21E-10). Sum of fatty acids in plasma increased, although this was only significant for monounsaturated fatty acids (p = 0.03). Credit Correspondence to - Johanna Mock-Ohnesorge - johanna.ohnesorge@med.uni-heidelberg.de Usage Restrictions Copyright: © 2021 Mock-Ohnesorge et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. License Licensed content Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.