Biochemistry · MU Sofia

29. Ketogenesis

Explains ketogenesis in the liver as a fuel-supplying process during low carbohydrate availability, covering triggers and fatty acid substrates, the steps from beta-oxidation to acetoacetate, reduction to β-hydroxybutyrate and decarboxylation to acetone. It then describes ketone body use in muscle, brain and heart, ketonemia and ketonuria, starvation ketoacidosis and diabetic ketoacidosis, with symptoms and treatment, and ends with four multiple-choice questions and answers.

Inside: 10 sections · 1 labelled picture · 10 flashcards · 4 min

Topic 29 of 70 in the MU Sofia syllabus for Biochemistry (Medicine, Year 2). The free AceMed note covers it in 10 sections, about 634 words (4 min of reading), with 10 flashcards.

In this note

  1. Introduction
  2. Ketogenesis
  3. Enzymatic Steps:
  4. Utilization and Oxidation of Ketone Bodies in Extrahepatic Tissues
  5. Ketonemia
  6. Ketonuria
  7. Ketoacidosis in Starvation
  8. Diabetic Ketoacidosis (DKA)
  9. MCQs ☺
  10. Answers

Ketogenesis

Ketogenesis is a complex biochemical process that occurs primarily in the liver. It plays a crucial role in providing alternative fuel sources for the body, particularly during periods of low carbohydrate availability, such as fasting, starvation, or adherence to a ketogenic diet. In essence, ketogenesis enables the synthesis of ketone bodies, which serve as an alternative energy substrate to glucose.

Substrates and Triggers

  • Low Carbohydrate Availability: Ketogenesis is triggered when the body's carbohydrate stores, primarily glycogen, become depleted. This can occur during fasting, prolonged exercise, or carbohydrate-restricted diets.
  • Fatty Acids: The primary substrates for ketogenesis are fatty acids derived from adipose tissue triglycerides or dietary fat. These fatty acids are released into the bloodstream and transported to the liver for further processing.

Enzymatic Steps:

  • Fatty Acid Oxidation: Fatty acids are broken down into acetyl-CoA molecules through beta-oxidation in the mitochondria.
  • Acetyl-CoA Formation: Excess acetyl-CoA produced from beta-oxidation overwhelms the citric acid cycle, leading to the formation of ketone bodies.
  • Ketone Body Synthesis: Acetyl-CoA molecules condense to form acetoacetate, which is subsequently reduced to β-hydroxybutyrate or decarboxylated to form acetone.

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