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Old 05-10-2011
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Biochemistry B-hydroxybutyrate favored in high redox states?

So first aid says (pp 112, 2010 edition) that b-hydroxybutyrate is favored in high redox states. How is this the case?

From what I understand, a high redox state is an increased NAD+/NADH ratio, however the conversion from acetoacetate to b-hydroxybutyrate requires the conversion of one NADH to NAD+ (Goljan mentions in his audio lectures that this is why the ketones in alcoholic ketoacidosis are all b-hydroxybutyrate, because of the massive NADH overload).

Wouldn't having a high NAD+/NADH ratio then favor acetoacetate rather than b-hydroxybutyrate?
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Old 05-10-2011
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Thumbs Up You are right

A low redox state (NAD+/NADH) (example DKA) favors hydroxybutyrate.
A high redox state (NAD+/NADH) (example DKA recovery) favors acetoacetate.

So you are right. I think it's an error in FA, however, if you read carefully they said
"Urine Test for ketones does not detect hydroxybutyrate (favored in high redox states)" So they probably refer to the no detection of hydroxybutyrate in high redox state.
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Old 05-12-2011
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Ahhh, excellent catch. Thank you, Lee!
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