title: Ketone body metabolism and cardiovascular disease.
abstract: Ketone bodies are metabolized through evolutionarily conserved pathways that support bioenergetic homeostasis, particularly in brain, heart, and skeletal muscle when carbohydrates are in short supply. The metabolism of ketone bodies interfaces with the tricarboxylic acid cycle, β-oxidation of fatty acids, de novo lipogenesis, sterol biosynthesis, glucose metabolism, the mitochondrial electron transport chain, hormonal signaling, intracellular signal transduction pathways, and the microbiome. Here we review the mechanisms through which ketone bodies are metabolized and how their signals are transmitted. We focus on the roles this metabolic pathway may play in cardiovascular disease states, the bioenergetic benefits of myocardial ketone body oxidation, and prospective interactions among ketone body metabolism, obesity, metabolic syndrome, and atherosclerosis. Ketone body metabolism is noninvasively quantifiable in humans and is responsive to nutritional interventions. Therefore, further investigation of this pathway in disease models and in humans may ultimately yield tailored diagnostic strategies and therapies for specific pathological states.
authors: Department of Medicine, Center for Cardiovascular Research, Washington University, Saint Louis, Missouri 63110, USA.
authors: David G
authors: DG
authors: Cotter
authors: Rebecca C
authors: RC
authors: Schugar
authors: Peter A
authors: PA
authors: Crawford
mesh_terms: D000818:Animals; D009202:Cardiomyopathies / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000378:metabolism*; D015256:Coenzyme A-Transferases / Q000378:metabolism; D005227:Fatty Acids / Q000378:metabolism; D006801:Humans; D006904:Hydroxymethylglutaryl-CoA Synthase / Q000378:metabolism; D007657:Ketone Bodies / Q000378:metabolism*; D050155:Lipogenesis / Q000502:physiology; D008099:Liver / Q000378:metabolism; D008929:Mitochondria, Heart / Q000378:metabolism; D008930:Mitochondria, Liver / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism; D009765:Obesity / Q000378:metabolism; D010084:Oxidation-Reduction; D015398:Signal Transduction
chemical_list: D005227:Fatty Acids; D007657:Ketone Bodies; D006904:Hydroxymethylglutaryl-CoA Synthase; D015256:Coenzyme A-Transferases
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