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Ketosis - What is Ketosis?

In biology, ketosis is a state of the organism characterised by elevated levels of ketone bodies in the blood, by the processes of lipolysis and beta-oxidation.

Ketone bodies are formed from excess amount of fat break down. Some of these ketone bodies such as acetoacetate and ß-hydroxybutyrate can also be used for energy.

When glycogen stores are not available in the cells, fat (triacylglycerol) is cleaved to give 3 fatty acid chains and 1 glycerol molecule in a process called lipolysis.

Most of the body is able to utilize fatty acids as an alternative source of energy in a process in which fatty acid chains are cleaved by coenzyme A (CoA) to form acetyl-CoA, which can then be fed into the Krebs cycle.

Acetyl-CoA can only enter the Krebs cycle bound to oxaloacetate. When carbohydrate supplies are inadequate to maintain blood glucose levels, the liver naturally converts oxaloacetate in the liver to glucose via gluconeogenesis for use by the brain and other tissues.

Excess acetyl-CoA in the liver is used to produce ketone bodies, leading to a state of ketosis. During this process, a high concentration of glucagon is present in the serum, which inactivates hexokinase and phosphofructokinase-1 (regulators of glycolysis) indirectly, causing most cells in the body to use fatty acids as their primary energy source.

The brain cannot use fatty acids for energy because the fatty acids cannot cross the blood-brain barrier. However, the ketone bodies produced in the liver can cross the blood-brain barrier. In the brain, these ketone bodies are then incorporated into acetyl-CoA and used in the Krebs cycle.

Excess ketone bodies will slowly decarboxylate into acetone. Acetone is excreted in the breath and urine.

Ketosis should not be confused with ketoacidosis (diabetic ketoacidosis or the less common alcoholic ketoacidosis), which is severe ketosis causing the pH of the blood to drop below 7.2.

Ketoacidosis is a medical condition usually caused by diabetes and accompanied by dehydration, hyperglycemia, ketonuria, and increased levels of glucagon. The high-glucagon, low-insulin serum levels signal the body to produce more glucose via gluconeogenesis and glycogenolysis, and ketone bodies via ketogenesis. High levels of glucose causes the failure of tubular reabsorption in the kidneys, causing water to leak into the tubules in a process called osmotic diuresis, causing dehydration and further exacerbating the acidosis.

Further Reading


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