Ketogenesis

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Ketogenesis is the process by which ketone bodies are produced as a result of fatty acid breakdown.

Ketone bodies are produced mainly in the mitochondria of liver cells when carbohydrates are so scarce that energy must be obtained from breaking down fatty acids. Fatty acids are long chains of carbons with an acid group on one end. The body gets energy from fatty acids by breaking the carbon chain down into pieces that contain only two carbon atoms. These pieces are in the form of acetyl-CoA.

The three ketone bodies are acetoacetate, beta-hydroxybutyrate and acetone. (The first two are not technically ketones according to IUPAC nomenclature, but the third is.) Each of these is the product of acetyl-CoA molecules combining to make larger compounds.

Ketogenesis may or may not occur, dependent on how many carbohydrates are available. This is closely related to the paths of acetyl-CoA:

  • When the body has sufficient carbohydrates available, glucose is completely broken down to CO2, with acetyl-CoA as an intermediate, and the CoA is recycled in this process (the citric acid cycle and electron transfer).
  • When the body has excess carbohydrates available, some glucose is fully metabolized, some is broken down to acetyl-CoA, but not all the way to CO2, since not all of that energy is needed yet. Instead, acetyl-CoA molecules are combined to create fatty acids to save for later. (CoA is also recycled here.)
  • When the body has no carbohydrates available, fat must be broken down into acetyl-CoA in order to get energy. CoA is not being recycled through the citric acid cycle: it is being attached to more and more acetyl groups. You need more CoA to keep breaking down fats, and the only place to get it is from all those acetyl-CoA molecules, by attaching them to each other to get the CoA to fall off.
                                                                                                                   COO-   
                                                                COO-                                      H+       |        
     O                                                          |                                NAD+   NADH       CH2  β-hydroxy-   
     ||                        CH3                              CH2       Acetyl-CoA               \    /          |     butyrate 
CH3--C--S--CoA                 |           Acetyl-CoA           |              ^          COO-  -------------->   HC--OH        
                 tiolase       C===O              \        HO---C--CH3        /           |      βHB dehydro-      |    
      +         ----------->   |                   \            |            /            CH2       genase         CH3 
                     \         CH2    ------------------->      CH2     -------------->   |                    
     O                |        |          HMG-CoA    \          |          HMG-CoA        C==O        
     ||               V        C===O      synthase    |         C===O       liase         |                        CH3     
CH3--C--S--CoA       CoASH     |                      V         |                         CH3   -------------->    |      
                               S--CoA               CoASH       S--CoA                                (non-        C==O  +  CO2
                                                                                                    enzymatic)     |      
 2 Acetyl-CoA                                                                                                      CH3
                          Acetoacetyl-CoA                      HMG-CoA               Acetoacetate                               
                                                                                                                 Acetone    

HMG-CoA (β-hydroxy-β-methylglutaryl-CoA)is an intermediate in two important metabolic pathways - synthesis of cholesterol and synthesis of ketone bodies. Ketone bodies are created at moderate levels in everyone's bodies, such as during sleep and other times when no carbohydrates are available. However, when ketogenesis is happening at abnormally high levels, the body is said to be in a state of ketosis. It is unknown whether ketosis has negative long-term effects or not.

Both acetoacetate and beta-hydroxybutyrate are acidic, and, if levels of these ketone bodies are too high, the pH of the blood drops, resulting in ketoacidosis. This is very rare, and, in general, happens only in untreated Type I diabetes (see diabetic ketoacidosis) and in alcoholics after binge drinking and subsequent starvation (see alcoholic ketoacidosis).

See also