In liver, FGF21 stimulates gluconeogenesis, fatty acid oxidation, and
ketogenesis. In adipose tissue, FGF21 regulates glucose uptake, lipolysis, and mitochondrial oxidative capacity [23].
(14,27) OKA HHNS Onset Hours to days insidious (weeks) At risk T1DM T2DM T2DM in acute metabolic stress states Triggers Untreated hyerglycaemia Untreated hyerglycaemia Metabolic stress Metabolic stress Acute infection Acute infection Non-compliance with Non-compliance with insulin medication Very high carbohydrate intake Pathophysiology Absolute lack of insulin Some insulin present so triggers
ketogenesis no ketones formed.
DEHP induced the expression of genes controlling [beta]-oxidation of fatty acids in the liver as well as that of FGF-21, a novel PPAR[alpha] target important for lipid oxidation and
ketogenesis (Badman et al.
Inducing
ketogenesis using normal food products is not possible due to the impairment of fatty acid oxidation.
It is mostly expressed in the liver, where it regulates lipid catabolism (i.e., [beta]-oxidation) and critical genes (e.g., fatty acid transport protein 1, CD36, Acyl-CoA oxidase 1, and Carnitine palmitoyltransferase 1) involved in fatty acid transport [68] and in
ketogenesis (e.g., Hmgcs2, Hmgcl) [68].
Ketogenesis in the liver of ruminants-adaptations to a challenge.
Fibroblast growth factor 21 regulates lipolysis in white adipose tissue but is not required for
ketogenesis and triglyceride clearance in liver.
In hepatocytes, PPAR[alpha] promotes the expression of several genes involved in FA uptake, activation to acyl-CoA, and transport to the mitochondria or peroxisomes and subsequent [beta]- or [omega]-oxidation,
ketogenesis, and lipoprotein trafficking [25, 26] (Figure 1).
Phydroxybutyrate is the product of butyrate metabolism by rumen epithelial cells (
ketogenesis), but also may undergo oxidative metabolism through [beta]-oxidation and the citric acid cycle (Wiese et al., 2013).
Scharrer, "Control of food intake by fatty acid oxidation and
ketogenesis," Nutrition, vol.
Responses of leptin to short-term fasting and refeeding in humans: a link with
ketogenesis but not ketones themselves.
The role of insulin, glucagon, dexamethasone, and leptin in the regulation of
ketogenesis and glycogen storage in primary cultures of porcine hepatocytes prepared from 60 kg pigs.
