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October 6, 1945


JAMA. 1945;129(6):448-449. doi:10.1001/jama.1945.02860400032011

Formerly physiologists believed that ketone body formation was an abnormal metabolic process due to incomplete combustion of fatty acids and that it was necessary to metabolize carbohydrates in order to utilize the ketone bodies completely. As a result of the work of Mirsky, Soskin, Somogyi and others this concept has been questioned in recent years. Evidence exists that ketone bodies are metabolites which are normally present in the animal organism; when there is an increased production, acidosis results. Early workers showed by means of the tissue slice technic, by perfusion and by experiments on intact animals that ketone bodies are produced only by the liver but cannot be utilized by this tissue. Extrahepatic tissue, particularly muscle, can utilize a certain amount of acetone bodies for the production of energy, on which process insulin exerts little, if any, influence.1

Ketone bodies and ketosuria are usually associated with the acidosis of