Ketogenic and Antiketogenic Factors.—
The main ketones of the body are acetoacetate, acetone, and β-hydroxybutyrate, formed from acetoacetyl CoA in the liver. They are either excreted in the urine or oxidized, mainly by extrahepatic tissue. Whereas the body can utilize a large amount of ketone for energy, it is limited to approximately 1,500 calories per day, and consequently, when more ketones are formed than are oxidized or excreted, ketosis develops. The 2 major factors leading to ketosis are: (1) decreased glucose oxidation, and (2) increase in supply of fat to the liver. A high fat intake, particularly when accompanied by a very low carbohydrate and protein intake, is conducive to ketosis. Due to the marked decrease in glucose utilization found in diabetes, there is a pronounced tendency for ketosis. Among the factors promoting lipolysis and, consequently, ketosis, are epinephrine, levarterenol, growth hormone, corticotropin, glucosteroids (in diabetics), thyroxin, starvation,
WILLIAMS RH. Ketosis: Summarization. Arch Intern Med. 1961;107(1):69–74. doi:10.1001/archinte.1961.03620010073012
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