In humans fatty acids are predominantly formed in the liver and adipose tissue, and mammary glands during lactation. Most acetyl-CoA is formed from pyruvate by pyruvate dehydrogenase in the mitochondria. Acetyl-CoA produced in the mitochondria is condensed with oxaloacetate to form citrate, which is then transported into the cytosol and broken down to yield acetyl-CoA and oxaloacetate by ATP-citrate lyase.
Elongation
Much like ?-oxidation, elongation occurs via four recurring reactions shown below. In these diagrams, the acetyl and malonyl units are shown as their Acyl carrier protein thioesters: this is how fatty acids are synthesized in microorganisms and plants. However, in animals these same reactions occur on a large dimeric protein, Fatty acid synthase, which has the full complement of enzymatic activities required to synthesize and liberate a free fatty acid.
In this step, acetoacetyl ACP is reduced by NADPH into D-3-Hydroxybutyryl ACP. The double bond is reduced to a hydroxyl group. Only the D isomer is formed.
In the second step of elongation, butyrylACP condenses with malonyl ACP to form an acyl ACP compound. This continues until a C16 acyl compound is formed, at which point it is hydrolyzed by a thioesterase into palmitate and ACP.