Ketone bodies
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They are water soluble substances. 2. They are synthesized at a relatively low rate in well nourished individuals. 3. Plasma level of ketone bodies < 1mg/dl. 4. Urinary level of ketone bodies <3 mg/24 hour urine.
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Ketone bodies
- 1. KETONE BODIESKETONE BODIES Tapeshwar YadavTapeshwar Yadav ))LecturerLecturer(( BMLT, DNHEBMLT, DNHE,, M.Sc. Medical BiochemistryM.Sc. Medical Biochemistry
- 2. Ketone BodiesKetone Bodies They are; Acetoacetic acid CH3-CO-CH2-COOH β)3(-hydroxybutyric acid CH3-CHOH-CH2-COOH Acetone CH3-CO-CH3
- 3. KetogensesisKetogensesis Definition: It means Synthesis of ketone bodies. Site. Mitochondrial matrix of liver cells.
- 4. Steps of KetogensesisSteps of Ketogensesis
- 5. Properties of Ketone BodiesProperties of Ketone Bodies 1. They are water soluble substances. 2. They are synthesized at a relatively low rate in well nourished individuals. 3. Plasma level of ketone bodies < 1mg/dl. 4. Urinary level of ketone bodies <3 mg/24 hour urine.
- 6. 5. Acetone is synthesized in smaller amounts than other ketone bodies. It is a non-metabolized end product. It is a volatile substance that is excreted by the lungs in the expired air. 6. Acetoacetate and β-hydroxybutyrate are relatively strong acids.
- 7. KetolysisKetolysis Definition It is the utilization (oxidation) of ketone bodies. Site - Mitochondrial matrix of extra hepatic tissues especially kidney cortex, cardiac and skeletal muscles which normally use ketone bodies as a source of energy in preference to glucose. - The brain can utilize ketone bodies as a source of energy only during prolonged starvation and they provide about 75 % of its energy needs. .
- 8. Ketolysis does not occur in a. RBCs : due to absence of mitochondria b. Liver : due to absence of thiophorase enzyme that is required for the activation of ketone bodies .
- 9. Steps of KetolysisSteps of Ketolysis . CH3 – CH – CH2 - COOH OH β - hydroxybutyrate CH3 – C – CH2 - COOH O Acetoacetate NAD+ NADH+H+ 3ATPs ETC β - hydroxybutyrate dehydrogenase
- 10. Steps of KetolysisSteps of Ketolysis Thiophorase
- 11. Energetics of KetolysisEnergetics of Ketolysis Oxidation of one mole of 3-hydroxbutyrate 27 ATPs. Oxidation of one mole of acetoacetateate 24 ATPs
- 12. Relation between Ketogenesis and KetolysisRelation between Ketogenesis and Ketolysis
- 13. Ketoacidosis (Ketosis)Ketoacidosis (Ketosis) Definition It is a metabolic disorder characterized by a triad of : 1. Ketonemia (increase ketone bodies in blood). 2. ketonuria (increase ketone bodies in urine). 3. acetone (fruity) odor of breath. There are also dehydration, acidosis, coma, and death (if untreated). .
- 14. Causes of KetosisCauses of Ketosis 1. Prolonged starvation. 2. Severe dieting. 3. Uncontrolled diabetes mellitus.
- 15. Mechanism (Pathogenesis) of KetosisMechanism (Pathogenesis) of Ketosis In all types of ketosis, there is a decrease in insulin/glucagon ratio, so there is a defect in carbo- hydrate metabolism, so the body depends on oxidation of fat as the main source of energy. so, there is excessive lipolysis in adipose tissue that yields large amounts of glycerol and fatty acids. The latter are oxidized to produce large amounts of acetyl COA that can not enter the citric acid cycle due to deficiency of oxalo-acetate. Consequently, acetyl COA is diverted to the pathway of keto-genesis leading to excessive formation of ketone bodies i.e. ketosis.
- 16. Prolonged starvation Severe dieting Uncontrolled DM Mechanism of KetosisMechanism of Ketosis insulin Glucagon Lipolysis Plasma FFA
- 17. FA oxidation Acetyl COA that can not enter CAC due to defect in CHO metabolism Ketogenesis Ketosis
- 18. Consequences of Ketosis:- Metabolic acidosis. Smell of acetone. Osmotic diuresis. Loss of cations. Dehydration. Coma.
- 19. Diagnosis of Ketosis:- Rothera’s test. Estimation of serum electrolytes. Acid-base parameters. Glucose & Urea estimation.
- 20. Rothera’s test:- Saturate 5ml of urine with solid NH3SO4. Add a few drops of freshly prepared sodium nitroprusside followed by 2ml of liquid ammonia along the side of the test tube. Result:- Development of a purple ring indicates the presence of ketone bodies in urine.
- 21. Management of keto-acidosis:- Treatment is to give insulin & glucose. When glucose & insulin are given intravenously, potassium is trapped within the cells. Administration of bicarbonate, and maintenance of electrolyte and fluid balance are very important aspects.
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