Download - Ketosis
KETOSIS
DR ROHINI C SANE
PROFESSOR
DEPARTMENT OF BIOCHEMISTRY
DY PATIL MEDICAL COLLEGE MAURITIUS
TYPES OF KETONE BODIES
ACETONE ,
ACETO ACETIC ACID
BETA HYDROXY BUTYRIC ACID
PROPERTIES OF KETONE BODIES
WATER SOLUBLE
ENERGY YEILDING (ACETONE CANNOT BE METABOLISED )
KETOGENESIS
Acetyl Co A
Co ASH
Acetyl Co A
KETONEMIA
KETOSIS
SERUM NORMAL CONCENTRATION---- 1 mg/ml
Urine-----Trace (Rotheras Test)
KETONEMIA----( INCREASED CONCENTRATION OF SERUM KETONE BODIES
>100mg / dl)
KETONURIA-----(INCREASED CONCENTRATION IN URINE >500mg /dl)
KETOSIS---- KETONEMIA + KETONURIA
RATE OF SYNTHESIS > RATE OF UTILIZATION
DIEBETIS MELITUS / STARVATION
FACTORS AGGREVATING KETOSISDECREASED CONCENTRATION OF OAA (AS GLUCONEOGENESIS---INCREASED )
DECREASED ACETYL Co A UTILISATION
DECREASED TCA
INCREASED CONCENTRATION OF ACETYL Co A
FACTORS AGGREVATING KETOSISINCREASED FREE FATTY ACIDS
DECREASED ACETYL Co A CARBOXYLASE
DECREASED MALONYL Co A
INCREASED CARNITINE PALMITOYL TRANSFERASE
INCREASED ACYL CO A OXIDATION
INCREASED ACETYL COA
FACTORS AGGREVATING KETOSISINSULIN / GLUCAGON RATIO DECREASED
INCREASED LIPOLYSIS IN ADIPOSE TISSUE
INCREASED ACETYL Co A
KETONE BODIES
FACTORS AGGREVATING KETOSIS
KETOGENIC AMINO ACIDS
LEUCINE
LYSINE
TYROSINE
STARVATION
BETA OXIDATION ENZYMES (INCREASED) INCREASED HORMONE SENSITIVE LIPASE I
ACTIVITY
Acetyl Co A
KETONE BODIES HORMONES
FFA
Acetyl Co A
KETONE BODIES (BRAIN 48HR-20%
7 DAYS-60%
40 DAYS 70% )
STARVATIONMANIFESTATIONS
DISPLACEMENT OF VISCERAL ORGANS (ADIPOSE TISSUE
THINS OUT )
SKIN HANGS LOOSE
DECREASED ACETYL Co A CARBOXYLASE
DECREASED CITRATE SYNTHETASE
INCREASED TRANSLOCATION OF CITRATE TO CYTOSOL
DECREASED FATTY ACID SYNTHESIS
METABOLIC KETOACIDOSIS
HYPERVENTILATION
BREATH ---ACETONE –FRUITY ODOUR
DECREASED BICARBONATE
OSMOTIC DIURESIS
DEHYDRATION ,KETONURIA
LOSS OF SODIUM AGGRIVATING DEHYDRATION
INCREASED ACIDITY IN URINE
INCREASED AMMONIUM SECRETION &EXCRETION OF AMMONIUM CHLORIDE
FATTY LIVER( CARBOHYDRATE DECREASED ---DECREASED ALPHA GLYCEROL P ----DECREASED VLDL )------ACCUMULATION FAT IN LIVER
COMA
DEATH
EFFECTS OF KETOSIS
TREATMENT OF KETOSIS ( STARVATION)
INSULIN
GLUCOSE
ASPARTATE ----OAA---TCA-----ACETYL COA
CORRECTION OF ACIDOSIS& BICARBONATE
TREATMENT OF DIEBETIS KETOACIDOSIS
INSULIN
ASPARTATE
GLUCAGON STIMULATES KETOGENESIS
INSULIN INHIBITS KETOGENESIS