The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.
Ketone body production and disposal: Effects of fasting, diabetes, and exercise
Abstract
Turnover studies performed during progressive fasting in normal subjects indicate that the production rate and the concentration of KB rise markedly during the early phase of fasting and start reaching a plateau after about 5 days. In addition to increased production, a reduction in the metabolic clearance rate of KB contributes to the hyperketonemia. This reduced metabolic clearance rate reflects essentially the progressive saturation of muscular ketone uptake that occurs with increasing ketonemia. The hormonal and metabolic environment of fasting plays only a minor role in this process, since a fall in KB metabolic clearance similar to that observed during fasting is observed if hyperketonemia is artificially induced in the postabsorptive state by the infusion of exogenous ketones. As extraction of KB by muscle becomes limited during ongoing fasting, KB are preferentially taken up by the brain to serve as a substrate replacing glucose. The remarkable stability of ketonemia during prolonged fasting is maintained through the operation of a negative feedback mechanism whereby KB tend to restrain their own production rate. The antilipolytic and insulinotropic effects of KB are instrumental in this process. This homeostatic mechanism maintains ketogenesis only slightly above the maximal metabolic disposal rate, the difference corresponding to urinary excretion, which is always below 10% of total turnover under physiologic conditions. When type I insulin-deprived diabetic patients are compared at the same KB concentration with control subjects with fasting ketosis, the characteristics of KB kinetics are comparable in the two groups. The maximal KB removal capacity is identical in the two situations, and it is not possible to identify a ketone removal defect specific to diabetes. Thus, these data favor the concept that excessive production of KB represent the main factor leading to uncontrolled hyperketonemia. It should be realized that a production exceeding only slightly that prevailing during prolonged fasting is sufficient to cause a progressive build-up in concentration, leading to uncontrolled diabetic ketosis. In the overnight-fasted state, a prolonged exercise (2 h) performed at moderate intensity (50% VO2 max) stimulates the capacity of muscle to extract ketones from blood as evidenced by a stimulation of the metabolic clearance rate.(ABSTRACT TRUNCATED AT 400 WORDS)
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Cites
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Changes induced by exercise in rates of turnover and oxidation of ketone bodies in fasting man
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Kimura, I., Inoue, D., Maeda, T., Hara, T., Ichimura, A., Miyauchi, S., Kobayashi, M., Hirasawa, A., & Tsujimoto, G. (2011) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1016088108 · Cited by 1,106
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“Increased lysine acetylation of ATP citrate lyase (ACLY), a key enzyme in lipid biosynthesis, was found in human lung cancers and stabilizes ACLY to promote fatty acid biosynthesis and consequent tumor growth (Lin et al., 2013). c. ACAT1 is a key enzyme in ketogenesis by converting two acetyl-CoAs to acetoacetyl-CoA a…”
InfluentialVolek, J. S., Fernandez, M. L., Feinman, R. D., & Phinney, S. D. (2008) · Progress in Lipid Research · doi:10.1016/j.plipres.2008.02.003 · Cited by 288
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Tetrameric acetyl-CoA acetyltransferase 1 is important for tumor growth
Fan, J., Lin, R., Xia, S., Chen, D., Elf, S. E., Liu, S., Pan, Y., Xu, H., Qian, Z., Wang, M., et al. (2016) · Molecular Cell · doi:10.1016/j.molcel.2016.10.014 · Cited by 106
No Benefit of Ingestion of a Ketone Monoester Supplement on 10-km Running Performance
EVANS, M., MCSWINEY, F. T., BRADY, A. J., & EGAN, B. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002065 · Cited by 82
Tanner, H. L., Dekker Nitert, M., Callaway, L. K., & Barrett, H. L. (2021) · Diabetes Care · doi:10.2337/dc20-2008 · Cited by 46
International society of sports nutrition position stand: ketogenic diets
Leaf, A., Rothschild, J. A., Sharpe, T. M., Sims, S. T., Macias, C. J., Futch, G. G., Roberts, M. D., Stout, J. R., Ormsbee, M. J., Aragon, A. A., et al. (2024) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2024.2368167 · Cited by 23
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Metadata
- Authors
- Balasse, E. O., & Féry, F.
- Venue
- Diabetes/Metabolism Reviews
- Publisher
- Wiley
- Published
- 1989-05
- Volume
- 5
- Issue
- 3
- Pages
- 247-270
- ISSN
- 0742-4221 (ISSN-L)
- 1099-0895
- OpenAlex
- W2035657933
- Cited by
- 313
- References
- 3
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- closed
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