A method for quantitating the contributions of the pathways of acetoacetate formation and its application to diabetic ketosis in vivo.

A method has been developed for estimating in the intact cell the contribution of deacylation of acetoacetyl-CoA to the formation of acetoacetate relative to acetoacetate's formation via hydroxymethylglutaryl (HMG)-CoA. Estimates depend upon the fraction of the terminal four carbons of an even carbon-containing fatty acid that are converted to acetoacetate without prior conversion to acetyl-CoA, since in the formation of acetoacetate via HMG-CoA the omega-2 and omega-3 carbons of the fatty acid are converted to acetyl-CoA. Incorporation of 14C from [16-14C]palmitic acid into carbon 2 relative to carbon 4 of acetoacetate is used as the measure of the formation of the acetoacetate from the omega and omega-1 carbons of the fatty acid without acetyl-CoA as an intermediate. Incorporation of 14C from [13-14C]palmitic acid into carbon 1 relative to carbon 3 of acetoacetate is the measure of the formation of acetoacetate from the omega-2 and omega-3 carbons without acetyl-CoA as an intermediate. Comparison of these incorporations is made with incorporation into the carbons of acetoacetate of 14C from palmitic acid labeled with 14C in any of its first 12 carbons since such incorporation must proceed via acetyl-CoA as an intermediate. In an application of this approach, the specifically 14C-labeled palmitic acids were injected into rats in diabetic ketosis. Hydroxybutyric acid that each rat excreted was isolated and degraded. From the ratios of incorporation into the carbons of the hydroxybutyrates, as a minimum, 11% of the total quantity of hydroxybutyrate excreted by the rats was formed from acetoacetyl-CoA without HMG-CoA as an intermediate.