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Human ketone body production and utilization studied using tracer techniques : regulation by free fatty acids, insulin, catecholamines, and thyroid hormones

Keller, U. and Lustenberger, M. and Mueller-Brand, J. and Gerber, P. P. and Stauffacher, W.. (1989) Human ketone body production and utilization studied using tracer techniques : regulation by free fatty acids, insulin, catecholamines, and thyroid hormones. Diabetes metabolism reviews, Vol. 5, H. 3. pp. 285-298.

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Official URL: http://edoc.unibas.ch/dok/A6419894

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Abstract

Ketone body concentrations fluctuate markedly during physiological and pathological conditions. Tracer techniques have been developed in recent years to study production, utilization, and the metabolic clearance rate of ketone bodies. This review describes data on the roles of insulin, catecholamines, and thyroid hormones in the regulation of ketone body kinetics. The data indicate that insulin lowers ketone body concentrations by three independent mechanisms: first, it inhibits lipolysis, and thus lowers free fatty acid availability for ketogenesis; second, it restrains ketone body production within the liver; third, it enhances peripheral ketone body utilization. To assess these effects in humans in vivo, experimental models were developed to study insulin effects with controlled concentrations of free fatty acids, insulin, glucagon, and ketone bodies. Presently available data also support an important role of catecholamines in increasing ketone body concentrations. Evidence was presented that norepinephrine increases ketogenesis not only by stimulating lipolysis, and thus releasing free fatty acids, but also by increasing intrahepatic ketogenesis. Thyroid hormone availability was associated with lipolysis and ketogenesis. Ketone body concentrations after an overnight fast were only modestly elevated in hyperthyroidism resulting from increased peripheral ketone body clearance. There was a significant correlation between serum triiodothyronine levels and the ketone body metabolic clearance rate. Thus, ketone body homeostasis in human subjects resulted from the interaction of hormones such as insulin, catecholamines, and thyroid hormones regulating lipolysis, intrahepatic ketogenesis, and peripheral ketone body utilization.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Former Units at DBM > Metabolism (Keller/Müller)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Klinische Endokrinologie (Keller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Klinische Endokrinologie (Keller)
UniBasel Contributors:Keller, Ulrich O.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:John Wiley
ISSN:0742-4221
Note:Publication type according to Uni Basel Research Database: Journal article
Last Modified:04 Sep 2015 14:32
Deposited On:04 Sep 2015 14:32

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