FORM & FUNCTION (Ketone Bodies) Flashcards

1
Q

Acetyl-CoA:

A

-mitochondria can be converted into citrate or ketone bodies

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2
Q

Ketone bodies;

A

-small, water-soluble fatty acid produced by acetyl-CoA in the LIVER
>soluble because they have so little carbons
Ex. acetone, acetoacetate, D-b-hydroxybutyrate

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3
Q

Metabolically active ketone bodies;

A

-acetoacetate
-beta-hydroxybutyrate

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4
Q

D-b-hydroxybutyrate:

A

-aliphatic hydrocarbon and carboxylic acid

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5
Q

When are ketones synthesized?

A

-glucose deficiency
>prolonged starvation
>diabetes mellitus
>CHO restriction (Atkin’s diet)

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6
Q

Steps for when ketones are synthesized:

A

1.Depletion of CHO (primary metabolic fuel, for the brain)
2.Activation of FA oxidation to generate ATP
3.BUT, when glucose is low, oxaloacetate is used for gluconeogenesis
>Don’t have any oxaloacetate for FA’s to go into TCA
>Acetyl CoA cannot be converted to citrate to enter the TCA
4.Excess acetyl-CoA is shuttled into ketogenesis
>Circulate in the blood to feed other issues

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7
Q

Ketone as metabolic fuel:

A

-utilized by most aerobic tissues except the LIVER
-water-soluble equivalent of FA: can cross BBB and placental barrier

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8
Q

Why are ketones important as a metabolic fuel?

A

-FA while high in energy, must be bound to albumin to be soluble
-FFA-albumin cannot cross the BBB or placental barrier
*important source of fuel for brain and fetus during starvation in lieu of glucose

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9
Q

Ketone bodies: liver:

A

-liver doesn’t/can’t use any of the ketone it makes (goes to all other tissues)

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10
Q

Ketogenesis steps:

A
  1. 2 Acetyl-CoA are condensed to form acetoacetyl-CoA
  2. A 3rd Acetyl-CoA is added to from HMG-CoA by HMG-CoA synthase (rate-limiting step)
  3. HMG-CoA is degraded to yield acetoacetate and Acetyl-CoA
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11
Q

HMG-CoA synthase:

A

-inhibited by insulin (nutrient rich state)
-promoted by glucagon (nutrient starved state)

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12
Q

When NADH is in abundance (ketogenesis):

A

-acetoacetate can be converted to beta-OH-butyrate
-occurs when beta-oxidation is high
*high rate of fat breakdown increases beta-oxidation and elevates NADH
*both acetoacetate and beta-OH-butyrate are soluble compounds that cross BBB

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13
Q

Ketone dipstick:

A

-urine dipstick for ketone analysis will ONLY detect acetoacetate and not beta-hydroxybutyrate
-quick results, but can underestimate true ketone level

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14
Q

Ketone metabolism overview;

A

-provide source of acetyl-CoA in absence of glucose
-oxaloacetate is available in the brain (or other tissues) to couple with acetyl-CoA (gluconeogenesis primarily takes place in the liver)
*reduces the pressure to undergo gluconeogenesis (-6ATP)

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15
Q

Ketone prioritized to vital organs:

A

-brain (alternative metabolic fuel)
-muscle with physiological functions
>heart
>diaphragm
>smooth muscle in digestive tract
>myometrial smooth muslces
*can’t be used by RBC: don’t have mitochondria (can’t do aerobic respiration)

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16
Q

Negative effects of ketone:

A

-acetoacetate and beta-hydroxybutyrate are naturally acidic (pKa=3.5)
>donating H+ into the blood
>can lead to ketoacidosis (over longer periods of time)
-acetone (less severe)

17
Q

Ketoacidosis:

A

-ketosis from diet: 1-6mM ketone in blood
-ketoacidosis in unmanaged diabetes: 15-30mM ketone in blood

18
Q

Metabolic acidosis:

A

-H+ removes HCO3-, resulting in increased anion gap
*excess ketones lead to metabolic acidosis
>respiratory compensation (hyperventilate to reduce Pco2)

19
Q

Increase in anion gap:

A

-due to decrease in HCO3-
-total charge is still neutral
>acetoacetate/beta-hydroxybutyrate also increased

20
Q

Acetone: negative effects:

A

-third type of ketone
-metabolically inert
-spontaneous conversion of acetoacetate when concentration is high
-highly volatile, high vapour pressure
-excreted via urine or exhaled
-has a sweet or fruity smell, in the breath or urine of ketotic patients