Developmental Cardiology Laboratory, International Research Center for Medical Science (IRCMS), Kumamoto University.
J Atheroscler Thromb. 2023 Dec 1;30(12):1751-1758. doi: 10.5551/jat.RV22011. Epub 2023 Sep 28.
Ketone bodies, consisting of beta-hydroxybutyrate, acetoacetate, and acetone, are metabolic byproducts known as energy substrates during fasting. Recent advancements have shed light on the multifaceted effects of ketone body metabolism, which led to increased interest in therapeutic interventions aimed at elevating ketone body levels. However, excessive elevation of ketone body concentration can lead to ketoacidosis, which may have fatal consequences. Therefore, in this review, we aimed to focus on the latest insights on ketone body metabolism, particularly emphasizing its association with mitochondria as the primary site of interaction. Given the distinct separation between ketone body synthesis and breakdown pathways, we provide an overview of each metabolic pathway. Additionally, we discuss the relevance of ketone bodies to conditions such as nonalcoholic fatty liver disease or nonalcoholic steatohepatitis and cardiovascular diseases. Moreover, we explore the utilization of ketone body metabolism, including dietary interventions, in the context of aging, where mitochondrial dysfunction plays a crucial role. Through this review, we aim to present a comprehensive understanding of ketone body metabolism and its intricate relationship with mitochondrial function, spanning the potential implications in various health conditions and the aging process.
酮体由β-羟丁酸、乙酰乙酸和丙酮组成,是在禁食期间作为能量底物的代谢副产物。最近的研究进展揭示了酮体代谢的多方面影响,这导致了人们对旨在提高酮体水平的治疗干预措施的兴趣增加。然而,酮体浓度的过度升高会导致酮症酸中毒,这可能会产生致命的后果。因此,在本次综述中,我们旨在重点关注酮体代谢的最新研究进展,特别是强调其与线粒体的相互作用,线粒体是其主要的相互作用部位。鉴于酮体合成和分解途径之间的明显分离,我们对每个代谢途径进行了概述。此外,我们还讨论了酮体与非酒精性脂肪肝或非酒精性脂肪性肝炎和心血管疾病等疾病的相关性。此外,我们还探讨了酮体代谢的利用,包括饮食干预,在衰老背景下,线粒体功能障碍起着至关重要的作用。通过本次综述,我们旨在全面了解酮体代谢及其与线粒体功能的复杂关系,涵盖了其在各种健康状况和衰老过程中的潜在影响。