Chronic ketosis and cerebral metabolism

Authors

  • Dr. Darryl C. Devivo MD,

    Corresponding author
    1. Edward Mallinckrodt Department of Pediatrics and the Departments of Neurology and Neurosurgery (Neurology) and Pharmacology, Washington University School of Medicine, and the Division of Neurology, St. Louis Childern's Hospital, St. Louis, MO
    • St. Louis Children's Hospital, 500 Kingshighway, St. Louis, MO 63178
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  • Mary P. Leckie BS,

    1. Edward Mallinckrodt Department of Pediatrics and the Departments of Neurology and Neurosurgery (Neurology) and Pharmacology, Washington University School of Medicine, and the Division of Neurology, St. Louis Childern's Hospital, St. Louis, MO
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  • James S. Ferrendelli MD,

    1. Edward Mallinckrodt Department of Pediatrics and the Departments of Neurology and Neurosurgery (Neurology) and Pharmacology, Washington University School of Medicine, and the Division of Neurology, St. Louis Childern's Hospital, St. Louis, MO
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  • David B. McDougal Jr MD

    1. Edward Mallinckrodt Department of Pediatrics and the Departments of Neurology and Neurosurgery (Neurology) and Pharmacology, Washington University School of Medicine, and the Division of Neurology, St. Louis Childern's Hospital, St. Louis, MO
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Abstract

The effects of chronic ketosis on cerebral metabolism were determined in adult rats maintained on a high -fat diet for approximately three weeks and compared to a control group of animals. The fat-fed rats had statistically significantly lower blood glucose concentrations and higher blood β-hydroxybutyrate and acetoacetate concentrations; higher brain concentrations of bound glucose, glucose 6-phosphate, pyruvate, lactate, β-hydroxybutyrate, citrate, α-ketoglutarate, alanine, and adenosine triphosphate (ATP); lower brain concentration of fructose 1,6-diphosphate, aspartate, adenosine diphosphate (ADP), creatine, cyclic nucleotides, succinyl coenzyme A (CoA), acid-insoluble CoA, and total CoA; and similar brain concentrations of glucose, malate, calculated oxaloacetate, glutamate, glutamine, adenosine monophosphate, phosphocreatine, reduced CoA, acetyl CoA, sodium, potassium, chloride, and water content. The metabolite data in the chronically ketotic rats demonstrate an increase in the cerebral energy reserve and energy charge. These data also suggest negative modification of the enzymes phosphofructokinase, pyruvic dehydrogenase, and β-ketoglutaric dehydrogenase; positive modification of glycogen synthase; and possible augmentation of the hexose transport system. There was no demonstrable difference in brain pH, water content, or electrolytes in the two groups of animals. We speculate that the increased brain ATP/ADP ratio is central to most, if not all, the observed metabolic perturbations and may account for the increased neuronal stability that accompanies chronic ketosis.

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