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Am J Physiol Heart Circ Physiol. 2013 Apr 15;304(8):H1060-76. doi: 10.1152/ajpheart.00646.2012. Epub 2013 Feb 8.

Ketone body metabolism and cardiovascular disease.

Author information

1
Department of Medicine, Center for Cardiovascular Research, Washington University, Saint Louis, Missouri 63110, USA.

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.

PMID:
23396451
PMCID:
PMC3625904
DOI:
10.1152/ajpheart.00646.2012
[Indexed for MEDLINE]
Free PMC Article

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