1. Ketone Bodies

2. Ketone Bodies

4. Ketone Bodies: Acetyl-CoA produced in liver as a result of b oxidation, can go to TCA or it can be converted to ketone bodies and exported to other tissues for energy generation.
Ketone bodies are produced when glucose is not available as fuel source,

5. Cholesterol Biosynthesis
Stage 1: Condensation of Mevalonate from Acetate
Final step in β-oxidation of fatty acids in reverse (cytosolic)
Aldol condensation at C3 carbonyl to form HMG-CoA
Reduction of HMG-CoA
Committed step in biosynthesis of isoprenes
Requires 2 NADPH for reduction of carboxylate to alcohol

7. In cases of extreme starvation of untreated diabetes (in both cases glucose availability to tissues are very low), liver starts gluconeogenesis (synthesis of glucose). This process uses TCA cycle intermediates such as oxaloacetate, and thus the consumption of Acetyl-CoA in TCA cycle is slowed down.
These leads to excess of acetyl-CoA in liver.
In order to meet the energy demand by other tissues, liver catabolizes fatty acids, produces excess of acetyl-CoA and then produces ketone bodies which are tranported by blood to muscle and brain.
Ketone body formation regenerates free CoA which are required for b-oxidation.

10. In untreated diabetes, the concentration of ketone bodies (two of which are acids) in blood increases so much that it decreases the pH of blood. This condition is called “acidosis” which can lead to coma or death.
High concentration of ketone bodies in blood and urine is referred as “ketosis”. Due to high concentration of acetoacetate, which is converted to acetone, the breath and urine of the untreated diabetic patients smells like acetone.

11. In tissues that use ketone bodies, acetoacetate is condensed with CoA by transfer from succinyl CoA
acetoacetyl CoA can then be converted to two acetyl CoAs

12. Summary of Lipid Metabolism
From Voet, Voet and Pratt’s Fundamentals of Biochemistry