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Ketone bodies

Dr.E.Malligai

What are Ketone bodies ? • Substances synthesized from Acetyl CoA • Acidic in nature • Can produce Energy • They are of three different types .

Ketone Bodies Acetone Aceto acetate β hydroxy butyrate .

Synthesis & Catabolism Acetone. Acetoacetate. Acetoacetate&βhydroxybutyrate molecules serve as fuel(catabolized) in extrahepatic tissues.& βhydroxybutyrate —are synthesized in the liver. .

Ketone body synthesis .

Catabolism of Ketone bodies .

Energy synthesized by ketone bodies Acetoacetate gives 33 ATP bHydroxy butyrate gives 21 ATP .

 It will happen when there is excessive free fatty acid concentration and mellitus are two major conditions leading to increased free fatty acid concentration and other sources for excessive free fatty acid .Facts About Ketone Bodies  It is synthesized in normal healthy individuals as well as in diseased persons.

.Overproduction of ketone bodies leads to ketoacidosis. Ketonemia & ketonuria are features of Ketoacidosis.

Ketoacidosis • Starvation / Low calorie diet/ Ketogenic diet • Uncontrolled Diabetes • Consumption of excessive Alcohol .

Development of Starvation Ketoacidosis Mobilization of TGL from Adipose tissue Lipolysis and liberation of free fatty acid FFA is taken for oxidation by different tissues Liver takes up 30% of FFA from circulation When FFA is oxidised acetyl CoA is generated Acetyl CoA is oxidised in TCA cycle to generate ATP When there is excessive production it is turned towards Ketone body production .

Development of Diabetes Ketoacidosis Mobilization of TGL from Adipose tissue Lipolysis and liberation of free fatty acid FFA is taken for oxidation by different tissues Liver takes up 30% of FFA from circulation When FFA is oxidised acetyl CoA is generated Acetyl CoA is oxidised in TCA cycle to generate ATP When there is excessive production it is turned towards Ketone body production .

Features of KetoAcidosis • • • • • • • • High levels of ketones in serum Decrease in the pH(due to ketones) Decrease in serum Bicarbonates(to neutralise acidity) Features of Metabolic acidosis Increased Anion Gap Low sodium & potassium (loss in vomiting & in urination) Ketone excretion in urine Only the blood glucose level differentiate between the the starvation & diabetic Ketoacidosis .

induced by starvation • Elevated ratio of the reduced form of nicotinamide adenine dinucleotide (NADH) to nicotinamide adenine dinucleotide (NAD+) secondary to alcohol metabolism • Dehydration due to Alcohol • Volume depletion resulting from vomiting and poor oral intake of fluids .72 hours after Alcohol debauch • The main predisposing events in Alcoholic KetoAcidosis • Delay and decrease in insulin secretion and excess glucagon secretion.Alcoholic KetoAcidosis • Seen 24.