In DKA, which ketone body is the predominant circulating ketone contributing to metabolic acidosis?

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Multiple Choice

In DKA, which ketone body is the predominant circulating ketone contributing to metabolic acidosis?

Explanation:
In diabetic ketoacidosis, the liver makes ketone bodies from fatty acids because insulin is low and hormones signal more fat breakdown. The balance between the different ketone bodies is driven by the cellular redox state. When NADH is high, acetoacetate is preferentially converted to beta-hydroxybutyrate, so beta-hydroxybutyrate becomes the most abundant circulating ketone. This shift means it is the main contributor to the metabolic acidosis seen in DKA. Acetone, while produced, is mostly volatile and doesn’t drive acidosis, and acetoacetyl-CoA is an intermediate rather than a circulating ketone body.

In diabetic ketoacidosis, the liver makes ketone bodies from fatty acids because insulin is low and hormones signal more fat breakdown. The balance between the different ketone bodies is driven by the cellular redox state. When NADH is high, acetoacetate is preferentially converted to beta-hydroxybutyrate, so beta-hydroxybutyrate becomes the most abundant circulating ketone. This shift means it is the main contributor to the metabolic acidosis seen in DKA. Acetone, while produced, is mostly volatile and doesn’t drive acidosis, and acetoacetyl-CoA is an intermediate rather than a circulating ketone body.

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