Effect of long‐term starvation on acetate and ketone body metabolism in obese patients

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Abstract
The turnover of ketone bodies and acetate was evaluated as well from the disappearance rate of (3‐14C)acetoacetate or (1‐14C)acetate respectively as from the conversion of FFA into these metabolites in normal weight and obese overnight‐fasted and in obese long‐term starved patients. The disappearance rate of (1‐14C)oleate was the same in all three groups.Long‐term starvation enhanced ketone body turnover almost 10‐fold, whereas the disappearance rate for ketone bodies decreased from 0·035 to 0·015 min‐1. Under the same circumstances the turnover of acetate was about 1 μmol g‐1 min‐1 accounting for about 5% of FFA turnover.Long‐term starvation decreased the conversion of (1‐14C)oleate into triglycerides by almost 50% and increased the (2‐C)‐(4‐C)/(1‐C) ratio of radioactivity in ketone bodies. The reincorporation of radioactivity from the (1‐C)position of (1‐14C)oleate into the ((2‐C)‐(n‐C)) position of FFA, which is a measure of the reutilization of acetyl‐CoA for FFA synthesis decreased significantly during long‐term starvation.

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