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How Ketones Are Formed?

Blood Ketones

Blood Ketones

On This Site Tests: Urine Ketones (see Urinalysis - The Chemical Exam); Blood Gases; Glucose Tests Elsewhere On The Web Ask a Laboratory Scientist Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, the American Society for Clinical Laboratory Science (ASCLS). Click on the Contact a Scientist button below to be re-directed to the ASCLS site to complete a request form. If your question relates to this web site and not to a specific lab test, please submit it via our Contact Us page instead. Thank you. Continue reading >>

Ketone Bodies Formed In The Liver Are Exported To Other Organs

Ketone Bodies Formed In The Liver Are Exported To Other Organs

Ketone Bodies In human beings and most other mammals, acetyl-CoA formed in the liver during oxidation of fatty acids may enter the citric acid cycle (stage 2 of Fig. 16-7) or it may be converted to the "ketone bodies" acetoacetate, D-β-hydroxybutyrate, and acetone for export to other tissues. (The term "bodies" is a historical artifact; these compounds are soluble in blood and urine.) Acetone, produced in smaller quantities than the other ketone bodies, is exhaled. Acetoacetate and D-β-hydroxybutyrate are transported by the blood to the extrahepatic tissues, where they are oxidized via the citric acid cycle to provide much of the energy required by tissues such as skeletal and heart muscle and the renal cortex. The brain, which normally prefers glucose as a fuel, can adapt to the use of acetoacetate or D-β-hydroxybutyrate under starvation conditions, when glucose is unavailable. A major determinant of the pathway taken by acetyl-CoA in liver mitochondria is the availability of oxaloacetate to initiate entry of acetyl-CoA into the citric acid cycle. Under some circumstances (such as starvation) oxaloacetate is drawn out of the citric acid cycle for use in synthesizing glucose. When the oxaloacetate concentration is very low, little acetyl-CoA enters the cycle, and ketone body formation is favored. The production and export of ketone bodies from the liver to extrahepatic tissues allows continued oxidation of fatty acids in the liver when acetyl-CoA is not being oxidized via the citric acid cycle. Overproduction of ketone bodies can occur in conditions of severe starvation and in uncontrolled diabetes. The first step in formation of acetoacetate in the liver (Fig. 16-16) is the enzymatic condensation of two molecules of acetyl-CoA, catalyzed by thiolase; this is simply Continue reading >>

Ketone Bodies: Formation And Utilisation | Living Organisms | Biology

Ketone Bodies: Formation And Utilisation | Living Organisms | Biology

ADVERTISEMENTS: In this article we will discuss about:- 1. Formation of Ketone Bodies 2. Conditions Leading to Ketosis 3. Source 4. Utilisation 5. Interrelation with Carbohydrate Metabolism 6. Ratio 7. Relation of Ketosis with Blood and Urine Reaction 8. Role of Endocrine. Formation of Ketone Bodies (Ketogenesis): It has been observed that acetyl CoA produced during fatty acid oxidation condense with oxalo-acetic acid for oxidation in the TCA cycle. The oxalo-acetic acid formation is depressed when glucose supply is restricted so that in this condition acetyl CoA cannot be properly metabolized through citric acid cycle. Thus acetyl CoA condenses to form aceto-acetyl CoA which in the liver produces aceto-acetic acid. The aceto-acetic acid is reduced to form β-hydroxybutyric acid which after decarboxylation forms acetones. Acetoacetic acid, acetone and β-hydroxybutyric acid are called ketone bodies. The process of formation of ketone bodies is called ketogenesis. Normally the ketone bodies are utilized without being accumulated in the body, but they may be abnormally accumulated in body fluids known as ketosis and excreted through the urine called ketonuria (or acetonuria). Its accumulation in the blood is called ketonemia. Site of Formation of Ketone Bodies: Liver is perhaps the only site where ketone bodies are normally formed since concentration of ketone bodies have been found to be higher in the hepatic vein than in other veins. Antiketogenic Substances: These are substances which prevent the formation of ketone bodies. They include the following: (1) All carbohydrates, (2) 60% of proteins (antiketogenic amino acids) from which sugar may be formed and (3) 10% of fats (the glycerol part) Conditions Leading to Ketosis: The following conditions produce ketosis: (a) Di Continue reading >>

Synthesis Of Ketones

Synthesis Of Ketones

Like aldehydes, ketones can be prepared in a number of ways. The following sections detail some of the more common preparation methods: the oxidation of secondary alcohols, the hydration of alkynes, the ozonolysis of alkenes, Friedel‐Crafts acylation, the use of lithium dialkylcuprates, and the use of a Grignard reagent. The oxidation of secondary alcohols to ketones may be carried out using strong oxidizing agents, because further oxidation of a ketone occurs with great difficulty. Normal oxidizing agents include potassium dichromate (K 2Cr 2O 7) and chromic acid (H 2CrO 4). The conversion of 2‐propanol to 2‐propanone illustrates the oxidation of a secondary alcohol. The addition of water to an alkyne leads to the formation of an unstable vinyl alcohol. These unstable materials undergo keto‐enol tautomerization to form ketones. The hydration of propyne forms 2‐propanone, as the following figure illustrates. When one or both alkene carbons contain two alkyl groups, ozonolysis generates one or two ketones. The ozonolysis of 1,2‐dimethyl propene produces both 2‐propanone (a ketone) and ethanal (an aldehyde). Friedel‐Crafts acylations are used to prepare aromatic ketones. The preparation of acetophenone from benzene and acetyl chloride is a typical Friedel‐Crafts acylation. The addition of a lithium dialkylcuprate (Gilman reagent) to an acyl chloride at low temperatures produces a ketone. This method produces a good yield of acetophenone. Hydrolysis of the salt formed by reacting a Grignard reagent with a nitrile produces good ketone yields. For example, you can prepare acetone by reacting the Grignard reagent methyl magnesium bromide (CH 3MgBr) with methyl nitrile (CH 3C&tbond;N). Continue reading >>

Diabetic Ketoacidosis- Enzyme For Ketones Formation?

Diabetic Ketoacidosis- Enzyme For Ketones Formation?

Case details A 54- year-old man with Type 1 diabetes is referred to an ophthalmologist for evaluation of developing cataract. Blood chemistry results are shown below- Fasting blood glucose 198 mg/dl Hemoglobin A 15 gm/dl Hemoglobin A 1c 10% of total Hb Urine ketones Positive Urine glucose Positive Which of the following enzymes is most strongly associated with ketones formation in this patient? A) Pyruvate dehydrogenase complex B) Thioesterase C) Thiophorase D) Thiokinase E) Thiolase. The correct answer is- E- Thiolase. Out of the given options thiolase is the only enzyme involved in the ketogenesis. The process of ketogenesis starts from the action of thiolase. In fact, the actual specific enzyme for ketogenesis is HMG Co A Synthase (mitochondrial isoform) which is not mentioned in the given options. Ketone bodies Acetoacetate, D (-3) -hydroxybutyrate (Beta hydroxy butyrate), and acetone are often referred to as ketone bodies (figure-1). Figure-1- Acetoacetate is the primary ketone body, the other ketone bodies are derived from it. The term “ketones” is actually a misnomer because beta-hydroxybutyrate is not a ketone and there are ketones in blood that are not ketone bodies, e.g., pyruvate, fructose. Ketogenesis takes place in liver using Acetyl co A as a substrate or a precursor molecule. Enzymes responsible for ketone body formation are associated mainly with the mitochondria. Steps of synthesis Acetoacetate (First ketone body) is formed from acetyl CoA in three steps (Figure-2). 1) Two molecules of acetyl CoA condense to form Acetoacetyl CoA. This reaction, which is catalyzed by thiolase, is the reverse of the thiolysis step in the oxidation of fatty acids. 2) Acetoacetyl CoA then reacts with acetyl CoA and water to give 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) Continue reading >>

Ketosis

Ketosis

There is a lot of confusion about the term ketosis among medical professionals as well as laypeople. It is important to understand when and why nutritional ketosis occurs, and why it should not be confused with the metabolic disorder we call ketoacidosis. Ketosis is a metabolic state where the liver produces small organic molecules called ketone bodies. Most cells in the body can use ketone bodies as a source of energy. When there is a limited supply of external energy sources, such as during prolonged fasting or carbohydrate restriction, ketone bodies can provide energy for most organs. In this situation, ketosis can be regarded as a reasonable, adaptive physiologic response that is essential for life, enabling us to survive periods of famine. Nutritional ketosis should not be confused with ketoacidosis, a metabolic condition where the blood becomes acidic as a result of the accumulation of ketone bodies. Ketoacidosis can have serious consequences and may need urgent medical treatment. The most common forms are diabetic ketoacidosis and alcoholic ketoacidosis. What Is Ketosis? The human body can be regarded as a biologic machine. Machines need energy to operate. Some use gasoline, others use electricity, and some use other power resources. Glucose is the primary fuel for most cells and organs in the body. To obtain energy, cells must take up glucose from the blood. Once glucose enters the cells, a series of metabolic reactions break it down into carbon dioxide and water, releasing energy in the process. The body has an ability to store excess glucose in the form of glycogen. In this way, energy can be stored for later use. Glycogen consists of long chains of glucose molecules and is primarily found in the liver and skeletal muscle. Liver glycogen stores are used to mai Continue reading >>

Ketone Bodies

Ketone Bodies

Sort Ketone Bodies -->Represent 3 molecules that are formed when excess acetyl CoA cannot enter the TCA Cycle -->Represents 3 major molecules: 1)Acetoacetate 2)β-Hydroxybutyrate 3)Acetone -->Normal people produces ketones at a low rate -->Are only formed in the **LIVER**(by liver mitochondria) Reactions that lead to the formation of ketone bodies (***See pwrpt***) 1)2 Acetyl CoA molecules condense to form ***Acetoacetyl-CoA -->Is catalyzed by THIOLASE -->Represent the oppostie of thiolysis step in the oxidation of fatty acids -->Represent the parent compound of the 3 ketone bodies (2)Acetoacetyl CoA then reacts with another mol. of acetyl CoA to form **HMG-CoA* (3-hydroxy-3-methylglutaryl CoA) & *CoA** -->Reaction is catalyzed by **HMG-CoA Synthetase** -->HMG-CoA has 2 fates (can either progress to form ketone bodies OR can enter the pathway of CHOLESTEROL synthesis) -->Represent the **RATE-LIMITING STEP** in the synthesis of ketone bodies (3)HMG-CoA is cleaved to form **Acetoacetate**(First major ketone; represent ~20% of ketones) & another mol. of acetyl CoA -->Catalyzed by **HMG-CoA Lyase** (4) Acetoacetae can lead to the formation of β-hydroxybutyrate (~78% of ketone bodies) & Acetone (~2% of ketone bodies) via 2 separte reactions Interrelationships of the ketone bodies from Acetoacetate (1)Formation of β-hydroxybutyrate -->Acetoacetate will be reduced to form β-hyroxybutyrate in the mitochondrial matrix of the liver cell -->Is a REVERSIBLE RXN. -->Requires 1 mol of NADH (***Dependent on the NADH/NAD ratio inside the mitochondria) -->Catalyzed by β-hydroxybutyrate dehydrogenase (2)Formation of Acetone -->A slower, **spontaneous** decarboxylation to acetone -->In **DIABETIC KETOACIDOSIS, acetone imparts a characteristic smell to the patient's breath Features of Continue reading >>

Urine - For Ketone, Ketone Bodies (ketonuria)

Urine - For Ketone, Ketone Bodies (ketonuria)

Sample The is done on the urine. Indication It is advised in diabetic patients for the early diagnosis of ketoacidosis. To evaluate the diabetic patient in a coma. Definition Increased ketone bodies in blood are called Ketonemia. Increased excretion in the urine is called Ketonuria. Pathophysiology Ketone bodies are seen in case of decreased availability of carbohydrates like starvation or frequent vomiting. Another possibility is decreased utilization of carbohydrates like diabetes mellitus, and glycogen storage disease. High fat and low carbohydrates diet are ketogenic and increase ketone bodies in the blood. Ketones are the end product of fatty acid catabolism. Ketones are formed when the glucose as a source of energy is not present. This situation happens when there is no insulin so glucose cannot enter the cells. In that case, ketone bodies are the source of energy for the body, particularly to the brain. In case of fasting for 3 to 4 days, then 30 to 40% body energy is provided by the ketone bodies. Ketones bodies are the end product of fatty acid breakdown and consists of : Beta-hydroxybutyric acid. Acetoacetic acid. Acetone. The β- hydroxybutyric acid + acetoacetic acid readily converts to acetone. In the blood: Acetone is the minor amount. Acetoacetate and β- hydroxybutyrate are equal in amount and are the main ketone bodies. in a healthy person, ketones are formed in the liver but there is a negligible amount in urine. The outcome of Increased Ketones in the blood leads to : Electrolyte imbalance. Dehydration. If not corrected then leads to acidosis coma and ultimately death. Ketones are present in the urine when a threshold level of ketones exceed the normal level in the blood. Normal In Urine Ketone bodies are negative. Small amount = < 20 mg/dL. Moderate Continue reading >>

Making Aldehydes And Ketones

Making Aldehydes And Ketones

This page explains how aldehydes and ketones are made in the lab by the oxidation of primary and secondary alcohols. Oxidising alcohols to make aldehydes and ketones General The oxidising agent used in these reactions is normally a solution of sodium or potassium dichromate(VI) acidified with dilute sulphuric acid. If oxidation occurs, the orange solution containing the dichromate(VI) ions is reduced to a green solution containing chromium(III) ions. The net effect is that an oxygen atom from the oxidising agent removes a hydrogen from the -OH group of the alcohol and one from the carbon to which it is attached. R and R' are alkyl groups or hydrogen. They could also be groups containing a benzene ring, but I'm ignoring these to keep things simple. If at least one of these groups is a hydrogen atom, then you will get an aldehyde. If they are both alkyl groups then you get a ketone. If you now think about where they are coming from, you will get an aldehyde if your starting molecule looks like this: In other words, if you start from a primary alcohol, you will get an aldehyde. You will get a ketone if your starting molecule looks like this: . . . where R and R' are both alkyl groups. Secondary alcohols oxidise to give ketones. Making aldehydes Aldehydes are made by oxidising primary alcohols. There is, however, a problem. The aldehyde produced can be oxidised further to a carboxylic acid by the acidified potassium dichromate(VI) solution used as the oxidising agent. In order to stop at the aldehyde, you have to prevent this from happening. Note: This further oxidation is explained in more detail on the page about oxidation of alcohols. If you choose to follow this link (not important for the purposes of the present page), use the BACK button on your browser to return to t Continue reading >>

Ketone Bodies As A Fuel For The Brain During Starvation

Ketone Bodies As A Fuel For The Brain During Starvation

THE STATUS OF OUR KNOWLEDGE OF STARVATION AND BRAIN METABOLISM IN HUMANS WHEN I BEGAN MY RESEARCH This story begins in the early 1960s when the general level of knowledge about whole-body metabolism during human starvation was grossly deficient. This was partly caused by a lack of accurate and specific methods for measuring hormones and fuels in biological fluids, which became available about 1965.11 Rigidly designed protocols for studying human volunteers or obese patients, who underwent semi- or total starvation for prolonged periods of time, were not widely employed, and much of the published data regarding metabolic events during starvation were not readily accessible. To complicate matters further, a great deal of the available data was confusing because much of the supposition regarding mechanisms used by the body to survive prolonged periods of starvation was based upon information that was obtained from nonstandardized and often erroneous procedures for studying metabolism. For example, the rate of urinary nitrogen excretion during starvation was sometimes confounded by the consumption of carbohydrate during the studies. Today, students of biochemistry take for granted the fact that tissues of the human body have a hierarchy of fuel usage. They know that the brain, an organ devoted to using glucose, can switch to use ketone bodies during prolonged starvation (2–3 days), thus sparing glucose for other tissues (i.e. red blood cells must use glucose as a fuel; without mitochondria, they have no choice!). However, this fundamental insight into human metabolism was not recognized in the early 1960s, when my research in this area began. How this simple but fundamental fact that ketone bodies provide critical fuels for the brain was discovered and its implication for Continue reading >>

Ketosis, Ketone Bodies, And Ketoacidosis – An Excerpt From Modern Nutritional Diseases, 2nd Edition

Ketosis, Ketone Bodies, And Ketoacidosis – An Excerpt From Modern Nutritional Diseases, 2nd Edition

The following text is excerpted from Lipids (Chapter 8) of Modern Nutritional Diseases, 2nd Edition. Ketone Bodies and Ketosis: Ketones are organic chemicals in which an interior carbon in a molecule forms a double bond with an oxygen molecule. Acetone, a familiar chemical, is the smallest ketone possible. It is composed of three carbons, with the double bond to oxygen on the middle carbon. Biological ketone bodies include acetone, larger ketones, and biochemicals that can become ketones. The most important of the ketone bodies are hydroxybutyrate and acetoacetate, both of which are formed from condensation of two acetyl CoA molecules. Acetone is formed from a nonenzymatic decarboxylation of acetoacetate. Ketone bodies are fuel molecules that can be used for energy by all organs of the body except the liver. The production of ketone bodies is a normal, natural, and important biochemical pathway in animal biochemistry (17, p. 577). Small quantities of ketone bodies are always present in the blood, with the quantity increasing as hours without food increase. During fasting or carbohydrate deprivation, larger amounts of ketone bodies are produced to provide the energy that is normally provided by glucose. Excessive levels of circulating ketone bodies can result in ketosis, a condition in which the quantity of circulating ketone bodies is greater than the quantity the organs and tissues of the body need for energy. People who go on extremely low-carbohydrate diets to lose a large excess of body fat usually go into a mild ketosis that moderates as weight is lost. There is no scientific evidence that a low-carbohydrate diet is capable of producing sufficient ketone bodies to be harmful. Excess ketone bodies are excreted by the kidneys and lungs. Exhaled acetone gives the brea Continue reading >>

What Are Ketones?

What Are Ketones?

What are ketones and what causes them? Ketones are the result of the body burning fat for energy or fuel. For a person with diabetes, ketones are often the result of prolonged high blood sugar and insulin deficiency. Without the right amount of insulin, glucose starts to build up in the blood stream and doesn't enter the cells. The cells burn fat instead of glucose, and ketones form in the blood and spill into the urine. Some causes of high blood sugar are: Missing an insulin dose or skipping some oral medications. A disconnected or blocked insulin pump tube. Being sick with the flu. High levels of stress. Eating more carbohydrates than your medication covers. What are the signs that I should test for ketones? Symptoms of high blood sugar include frequent urination, frequent thirst, blurry vision, dry mouth, vomiting, and fatigue. There are several scenarios that should prompt a test for ketones. If your blood sugar is over 240 mg/dl for two tests in a row. When you are ill. When your blood sugar is over 240 mg/dl and you are planning on exercising. If you are pregnant, you should test for ketones each morning before breakfast and whenever blood sugars are elevated. How do I test for ketones? There are two ways to test for ketones - by testing your urine or your blood. Ketones appear first in the blood stream and are later present in the urine, so testing your blood for ketones is the best way to check for an early problem. To check urine for ketones, you must collect a urine sample or dip a ketone test strip into a fresh stream of urine. After waiting for the time suggested by the ketone strip manufacturer, you compare the color strip to the chart on the bottle. The darker the color, the higher the amount of ketones in the urine. At this time, there are just a few mete Continue reading >>

How Much Do You Know About Ketones?

How Much Do You Know About Ketones?

Most people with diabetes – and anyone who has read about low-carbohydrate diets – has probably heard of ketones, but how many people really know what they are? Messages about ketones can be confusing: Some sources say they are toxic and dangerous, while others suggest that ketones are a positive sign of weight loss through fat burning. When you have diabetes, it’s important to know the facts about ketones, as well as when to check for them, how to check for them, and what to do if you detect them. Take this quiz to see how much you know about ketones. (You’ll find answers later in this article.) Q 1. What are ketones? A. Acids created in the liver. B. Fats released when blood glucose is high. C. Antifungal drugs. D. Hormones that are created only under special circumstances. 2. Which of the following statements about ketones is not true? A. Consuming very little carbohydrate can lead to the formation of ketones. B. Trace levels of ketones are generally harmless. C. There must be a very low level of insulin for dangerous amounts of ketones to form. D. Ketones cause weight loss. 3. All persons with diabetes should check for ketones when their blood glucose level is over 240 mg/dl. TRUE FALSE 4. Ketones can only be measured in the urine. TRUE FALSE 5. What is the role of ketones in the development of diabetic ketoacidosis (DKA), the acute diabetes complication characterized by high levels of ketones, high blood glucose, and dehydration? (More than one answer may be correct.) A. Ketones make the blood more acid. B. High levels of ketones cause dehydration. C. Ketones play a role in electrolyte loss. D. Ketones raise blood glucose. 6. People with Type 2 diabetes cannot develop diabetic ketoacidosis. TRUE FALSE 7. What steps are necessary to reduce ketones in the bod Continue reading >>

Diabetes And Ketones

Diabetes And Ketones

Tweet The presence of high levels of ketones in the bloodstream is a common complication of diabetes, which if left untreated can lead to ketoacidosis. Ketones build up when there is insufficient insulin to help fuel the body’s cells. High levels of ketones are therefore more common in people with type 1 diabetes or people with advanced type 2 diabetes. If you are suffering from high levels of ketones and seeking medical advice, contact your GP or diabetes healthcare team as soon as possible. What are ketones? Ketones are an acid remaining when the body burns its own fat. When the body has insufficient insulin, it cannot get glucose from the blood into the body's cells to use as energy and will instead begin to burn fat. The liver converts fatty acids into ketones which are then released into the bloodstream for use as energy. It is normal to have a low level of ketones as ketones will be produced whenever body fat is burned. In people that are insulin dependent, such as people with type 1 diabetes, however, high levels of ketones in the blood can result from taking too little insulin and this can lead to a particularly dangerous condition known as ketoacidosis. How do I test for ketones? Ketone testing can be carried out at home. The most accurate way of testing for ketones is to use a blood glucose meter which can test for ketones as well as blood glucose levels. You can also test urine for ketone levels, however, the testing of urine means that the level you get is representative of your ketone levels up to a few hours ago. Read about testing for ketones and how to interpret the results Who needs to be aware of ketones? The following people with diabetes should be aware of ketones and the symptoms of ketoacidosis: Anyone dependent on insulin – such as all people Continue reading >>

Ketones

Ketones

Excess ketones are dangerous for someone with diabetes... Low insulin, combined with relatively normal glucagon and epinephrine levels, causes fat to be released from fat cells, which then turns into ketones. Excess formation of ketones is dangerous and is a medical emergency In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketones can develop. What are ketones and why do I need to know about them? Ketones and ketoacids are alternative fuels for the body that are made when glucose is in short supply. They are made in the liver from the breakdown of fats. Ketones are formed when there is not enough sugar or glucose to supply the body’s fuel needs. This occurs overnight, and during dieting or fasting. During these periods, insulin levels are low, but glucagon and epinephrine levels are relatively normal. This combination of low insulin, and relatively normal glucagon and epinephrine levels causes fat to be released from the fat cells. The fats travel through the blood circulation to reach the liver where they are processed into ketone units. The ketone units then circulate back into the blood stream and are picked up by the muscle and other tissues to fuel your body’s metabolism. In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketone Continue reading >>

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