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X. Synthesis and Utilization of Ketone Bodies

              

Synthesis from acetyl CoA

Ketone bodies are synthesized from acetyl CoA.

• Ketone body synthesis from acetyl CoA occurs in hepatic mitochondria.
• First, acetoacetate is produced in a three-step process.
• Acetoacetate can be reduced to beta-hydroxybutyrate.
• Acetone also arises in small amounts as a biologically inert side product.

Ketone body production is regulated primarily by availability of acetyl CoA. If mobilization of fatty acids from adipose tissue is high, hepatic beta-oxidation will occur at a high rate, and so will synthesis of ketone bodies from the resulting acetyl CoA. The rate of ketone body production increases in starvation.