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Ketone bodies [1]
Ketone bodies are water-soluble molecules or compounds that contain the ketone groups produced from fatty acids by the liver (ketogenesis).[1][2] Ketone bodies are readily transported into tissues outside the liver, where they are converted into acetyl-CoA (acetyl-Coenzyme A)—which then enters the citric acid cycle (Krebs cycle) and is oxidized for energy.[3][4] These liver-derived ketone groups include acetoacetic acid (acetoacetate), beta-hydroxybutyrate, and acetone, a spontaneous breakdown product of acetoacetate (see graphic).. Ketone bodies are produced by the liver during periods of caloric restriction of various scenarios: low food intake (fasting), carbohydrate restrictive diets, starvation, prolonged intense exercise,[5] alcoholism, or during untreated (or inadequately treated) type 1 diabetes mellitus
(Glycogen stores typically are depleted within the first 24 hours of fasting.)[2]. Ketone bodies are also produced in glial cells under periods of food restriction to sustain memory formation [7]
β-hydroxybutyrate is a reduced form of acetoacetate, in which the ketone group is converted into an alcohol (or hydroxyl) group (see illustration on the right). Both are 4-carbon molecules that can readily be converted back into acetyl-CoA by most tissues of the body, with the notable exception of the liver
Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes [2]
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Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. – DOI: 10.1002/(sici)1520-7560(199911/12)15:63.0.co;2-8
Ketone bodies are produced by the liver and used peripherally as an energy source when glucose is not readily available. The two main ketone bodies are acetoacetate (AcAc) and 3-beta-hydroxybutyrate (3HB), while acetone is the third, and least abundant, ketone body
They are also found in the blood of neonates and pregnant women. Diabetes is the most common pathological cause of elevated blood ketones
What are Ketone Bodies? [3]
Ketone bodies are water soluble compounds containing ketone groups that are produced in the liver during caloric restrictions in the body. The process of formation of ketone bodies in the liver is referred to as ketogenesis
The three molecules that are referred to as ketone bodies are acetoacetate (AcAc), acetone and 3-β-hydroxybutyrate (3HB).. The ketone bodies are produced under circumstances such as prolonged fasting, intense exercise, starvation, diets restricted in carbohydrates, alcoholism and untreated conditions of type I diabetes mellitus, basically at times when the blood glucose level is low
But soon, the liver runs out of the glycogen storage and as a last resort the fatty acids are broken down to ketone bodies.. The ketone bodies are then transported out of the liver and converted into acetyl coenzyme A (acetyl-CoA)
Biochemistry, Ketogenesis [4]
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Treasure Island (FL): StatPearls Publishing; 2023 Jan-.. Ketogenesis is a metabolic pathway that produces ketone bodies, which provide an alternative form of energy for the body
In a state of ketosis, ketone body production is increased when there are decreased carbohydrates or increased fatty acids. However, ketoacidosis can occur if too many ketone bodies accumulate, such as in cases of uncontrolled diabetes.[1][2][3]
Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes [5]
Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. – DOI: 10.1002/(sici)1520-7560(199911/12)15:63.0.co;2-8
Ketone bodies are produced by the liver and used peripherally as an energy source when glucose is not readily available. The two main ketone bodies are acetoacetate (AcAc) and 3-beta-hydroxybutyrate (3HB), while acetone is the third, and least abundant, ketone body
They are also found in the blood of neonates and pregnant women. Diabetes is the most common pathological cause of elevated blood ketones
Ketone Bodies: Definition, Formation and Function [6]
Ketone bodies, or simply ketones are substances produced by the liver during gluconeogenesis, a process that creates glucose in times of fasting and starvation. There are three ketone bodies produced by the liver
These compounds are used in healthy individuals to provide energy to the cells of the body when glucose is low or absent in the diet.. Acetone (left), acetoacetate (middle), beta-hydroxybutyrate (right).
When you fast, or are being starved, the glucose levels in your blood quickly decrease. This triggers the body to enter the postabsorptive state
ketone body (CHEBI:73693) [7]
A carbonyl compound produced as a water-soluble byproduct when fatty acids are broken down for energy in the liver. There are three endogenous ketone bodies: acetone, acetoacetic acid, and (R)-3-hydroxybutyric acid; others may be produced as a result of the metabolism of synthetic triglycerides.
17.3: Ketone Bodies [8]
BMC Medicine (2021) 19:313 https://doi.org/10.1186/s12916-021-02185-0. Creative Commons Attribution 4.0 International License, http://creativecommons.org/licenses/by/4.0/.
Their structures are shown in Figure (PageIndex{1}).. They are synthesized when acetyl-CoA concentrations are high
– the acetyl-CoA produced can not enter the Kreb cycle leading to the buildup of acetyl-CoA in the matrix.. The latter condition arises when carbohydrate metabolism is compromised so the citric acid cycle has slowed
Ketone Bodies and Cardiovascular Disease: An Alternate Fuel Source to the Rescue [9]
Ketone Bodies and Cardiovascular Disease: An Alternate Fuel Source to the Rescue. Atherosclerotic Heart Disease/Coronary Artery Calcification
Mitochondrial Homeostasis Mediates Lipotoxicity in the Failing Myocardium. – Tozzi, R.; Cipriani, F.; Masi, D.; Basciani, S.; Watanabe, M.; Lubrano, C.; Gnessi, L.; Mariani, S
– Bendridi, N.; Selmi, A.; Balcerczyk, A.; Pirola, L. Ketone Bodies as Metabolites and Signalling Molecules at the Crossroad between Inflammation and Epigenetic Control of Cardiometabolic Disorders
The Role of Ketone Bodies in Improving Neurological Function and Efficiency [10]
ATP Ketones Bodies Ketogenic Diet Metabolic Function Neurons Physiology. Ketone bodies (KBs), characterized as lipid particles, water-soluble formed inside the liver tissue, can be utilized as a secondary source of energy if glucose is not able to provide enough energy
Acetone, beta-hydroxybutyrate, and acetoacetate are well-known ketone bodies which were generated during the absence of glucose or when the body cannot utilize it as energy in type 1 diabetes (1). Indeed, KBs should not be considered as a simple energy molecule required during synthesis of membrane in physiological development (2)
In fact, KBs are produced during a ketogenic diet or due to glucose starvation, which can influence many metabolic and regulatory enzymes, and subsequently substrates result in a neuroprotective, anti-oxidant, anti-inflammatory, anti-seizure, hyper excitability as well as synchrony in neurons (4). A ketogenic diet includes low carbohydrate- protein and high-fat meals consumption leading towards a starved state
Ketones in Pregnancy: Why Is It Considered Necessary to Avoid Them and What Is the Evidence Behind Their Perceived Risk? [11]
Current dietary advice for women with gestational diabetes mellitus is to avoid diets that result in elevated ketone levels. This guidance stems from a concern that maternal ketones are associated with poor fetal and childhood outcomes, including reduced childhood intelligence quota
Given that dietary counseling is the initial treatment strategy for women with diabetes in pregnancy, it is important that clinicians understand the concern regarding maternal ketones. This review examines the physiology of ketogenesis in pregnancy, the prevalence of elevated maternal ketone levels, and the relationship between maternal ketones and fetal and childhood outcomes.
Both articles recommended that women with gestational diabetes mellitus (GDM) consume a diet with adequate energy levels for appropriate gestational weight gain and absence of ketones. ADA dietary guidelines currently recommend a minimum of 175 g carbohydrate per day in women with diabetes in pregnancy (DIP) (3)
Ketone Bodies in the Brain Beyond Fuel Metabolism: From Excitability to Gene Expression and Cell Signaling [12]
Volume 14 – 2021 | https://doi.org/10.3389/fnmol.2021.732120. Ketone Bodies in the Brain Beyond Fuel Metabolism: From Excitability to Gene Expression and Cell Signaling
Ketone bodies are metabolites that replace glucose as the main fuel of the brain in situations of glucose scarcity, including prolonged fasting, extenuating exercise, or pathological conditions such as diabetes. Beyond their role as an alternative fuel for the brain, the impact of ketone bodies on neuronal physiology has been highlighted by the use of the so-called “ketogenic diets,” which were proposed about a century ago to treat infantile seizures
The fact that ketogenic diets have such a profound effect on epileptic seizures points to complex biological effects of ketone bodies in addition to their role as a source of ATP. In this review, we specifically focus on the ability of ketone bodies to regulate neuronal excitability and their effects on gene expression to respond to oxidative stress
Ketone bodies: from enemy to friend and guardian angel – BMC Medicine [13]
Ketone bodies: from enemy to friend and guardian angel. During starvation, fasting, or a diet containing little digestible carbohydrates, the circulating insulin levels are decreased
The hepatic energy metabolism is regulated so that under these circumstances, ketone bodies are generated from β-oxidation of fatty acids and secreted as ancillary fuel, in addition to gluconeogenesis. Increased plasma levels of ketone bodies thus indicate a dietary shortage of carbohydrates
It has been suggested that the beneficial non-metabolic actions of ketone bodies on organ functions are mediated by them acting as a ligand to specific cellular targets. We propose here a major role of a different pathway initiated by the induction of oxidative stress in the mitochondria during increased ketolysis
Ketone Bodies and Exercise Performance: The Next Magic Bullet or Merely Hype? [14]
Elite athletes and coaches are in a constant search for training methods and nutritional strategies to support training and recovery efforts that may ultimately maximize athletes’ performance. Recently, there has been a re-emerging interest in the role of ketone bodies in exercise metabolism, with considerable media speculation about ketone body supplements being routinely used by professional cyclists
Dietary strategies to increase endogenous ketone body availability (i.e., a ketogenic diet) require a diet high in lipids and low in carbohydrates for ~4 days to induce nutritional ketosis. However, a high fat, low carbohydrate ketogenic diet may impair exercise performance via reducing the capacity to utilize carbohydrate, which forms a key fuel source for skeletal muscle during intense endurance-type exercise
However, the extent to which ketone bodies regulate skeletal muscle bioenergetics and substrate metabolism during prolonged endurance-type exercise of varying intensity and duration remains unknown. Therefore, at present there are no data available to suggest that ingestion of ketone bodies during exercise improves athletes’ performance under conditions where evidence-based nutritional strategies are applied appropriately.
Changes in Arterial Ketone Body Ratio in the Phase Immediately After Hepatectomy [15]
• Postoperative fluctuations of the ketone body ratio in arterial blood (acetoacetate/3-hydroxybutyrate), reflecting hepatic mitochondrial redox potential, were analyzed in 266 hepatectomized patients in relation to their prognosis. Changes in ketone body ratio were classified into the following two types: a primary decrease at the end of operation and a secondary decrease after transient recovery
Ketone body ratio was restored to above 0.7 in 2.5 ± 0.2 days (mean ± SE) in all group 2 patients. However, though it was restored within 4.5 ± 0.4 days in 26 group 3 patients, the other 8 died of multiple organ system failure in 7.4±2.8 days without recovery of ketone body ratio
The degree of the secondary decrease was positively correlated with that of the primary decrease. In the secondary decrease, of 42 patients with ketone body ratio below 0.4, 28 died of multiple organ failure
What are Ketone Bodies? [16]
Ketone bodies are water soluble compounds containing ketone groups that are produced in the liver during caloric restrictions in the body. The process of formation of ketone bodies in the liver is referred to as ketogenesis
The three molecules that are referred to as ketone bodies are acetoacetate (AcAc), acetone and 3-β-hydroxybutyrate (3HB).. The ketone bodies are produced under circumstances such as prolonged fasting, intense exercise, starvation, diets restricted in carbohydrates, alcoholism and untreated conditions of type I diabetes mellitus, basically at times when the blood glucose level is low
But soon, the liver runs out of the glycogen storage and as a last resort the fatty acids are broken down to ketone bodies.. The ketone bodies are then transported out of the liver and converted into acetyl coenzyme A (acetyl-CoA)
Ketogenic Interventions [17]
Low carbohydrate & ketogenic diet mimicking tips for people with mild cognitive impairment, Alzheimer’s, Parkinson’s, & Lewy body dementia disorders. DISCLAIMER: There is increasing evidence suggesting that a combination of a low sugar/low carbohydrate intake combined with special types of fatty acids (ketones) may help people with mild cognitive impairment, Alzheimer’s, Parkinson’s & Lewy body dementia disorders
Please note that implementing this dietary changes does not constitute a patient-clinician relationship with physicians in the FNICOMO lab. Given risks associated with fatty acids or so-called ketogenic diet and the need for medical monitoring you should obtain professional advice from your doctor
The ketogenic diet is a high fat, low carb diet which offers many health benefits. The health benefits from the ketogenic diet result from a combination of special fatty acids called ketone bodies and reducing the amount of glucose and other carbohydrates
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- https://pubmed.ncbi.nlm.nih.gov/10634967/
- https://biologydictionary.net/ketone-bodies/
- https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:73693
- https://bio.libretexts.org/Bookshelves/Biochemistry/Fundamentals_of_Biochemistry_(Jakubowski_and_Flatt)/02%3A_Unit_II-_Bioenergetics_and_Metabolism/17%3A_Fatty_Acid_Catabolism/17.03%3A_Ketone_Bodies
- https://www.mdpi.com/1422-0067/24/4/3534
- https://brieflands.com/articles/healthscope-86578.html
- https://diabetesjournals.org/care/article/44/1/280/33020/Ketones-in-Pregnancy-Why-Is-It-Considered
- https://www.frontiersin.org/articles/10.3389/fnmol.2021.732120/full
- https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02185-0
- https://link.springer.com/article/10.1007/s40279-016-0577-y
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