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Ketone bodies M.Prasad Naidu MSc Medical Biochemistry, Ph.D.Research Scholar
Ketone bodies • Normally, total body needs of energy (ATP) is met by various fuels . • Carbohydrates (glucose) 70%. • Fat (fatty acids) 25%. • Proteins (Amino acids) 5%. • Ketone bodies normally negligible %. In a normal well fed person ketone body concentration is only < 1mg/dl. In prolonged starvation its concentration may increase up to 500mg/dl
Adipose tissue. During Starvation epinephrine, Glucagon Hormone sensitive lipase Lipolysis Fatty acid Beta oxidation in Liver Acetyl CoA
TCA cycle High NADH Low NADH Muscle , Myocardium Energy production
KETONE BODIES- SYNTHESISKetone body synthesis is active in 1. starvation and 2.uncontrolled diabetes mellitus Site of synthesis liver mitochondria ACETYL-COA + ACETYL-COA Thiolase ACETO-ACETYL-COA Acetyl CoAHMG CoA synthase CoA HMG CoA
HMG CoA Lyase HMG-COA CoA ACETO ACETIC ACID Dehydrogenase ACETONE 3-HYDROXY BUTYRATE NADH Sponteneous NAD+ CO2 3-HYDROXY BUTYRATE
Fate and utilization 3 Succinyl coA – Acetoacetate CoA Transferase (Thiophorase) • Fig 10.18 Utilization of Ketone bodies in Muscle , Myocadium for ATP production
Acetoacetate is major energy source in cardiac muscle and renal cortex; also in brain in starvation and diabetes
Ketones in Diabetes Mellitus • In presence of insulin: • Enhanced glucose uptake by tissues • Decreased mobilization of lipids by adipocytes • In absence of insulin: • Decreased glucose uptake by tissues • Increased mobilization of lipids by adipocytes
Regulation 1.Lipolysis of TAG 2. CAT-I 3. Acetyl co-A
Ketosis does not occur in vivo unless there is an increase in the level of circulating free fatty acids that arise from lipolysis of triacylglycerol in adipose tissue. • Free fatty acids are the precursors of ketone bodies in the liver.
The liver, both in fed and in fasting conditions, extracts about 30% of the free fatty acids passing through it, so that at high concentrations the flux passing into the liver is substantial. • Therefore, the factors regulating mobilization of free fatty acids from adipose tissue are important in controlling ketogenesis
Disorders • Fig 10.21 Ketonemia --- ketonuria -------- ketosis