The Significance of Ketosis

Citations Over TimeTop 10% of 1943 papers

Abstract

BY KETOSIS we understand the occurrence or accumulation in the blood in significant amounts of the so-called ketone bodies, namely beta-hydroxybutyric acid, acetoacetic (or diacetic) acid and, secondarily, acetone. In normal subjects on a general diet ketone bodies are present in the blood in inconsiderable amounts (Barnes and Wick, 1939). They appear in largest quantities in cases of severe diabetes and with normal subjects only when fasting or when the food carbohydrate is greatly restricted. Hirschfeld in 1895 (42) first showed that the factor common to these conditions and responsible for the ketosis is the absence of carbohydrate from the food or, as in the diabetic, from his metabolism. Today there is no question that ketosis is due to carbohydrate lack. Our ideas of how carbohydrate lack produces a ketosis have undergone many alterations. The old idea, first advanced by Geelmuyden in 1909 (39), that the ketone bodies represented incomplete oxidation products of the fatty acids which required the concomitant oxidation of carbohydrate metabolites for their utilization gained many adherents (93, 100, 94, 51) and the so-called ‘ketogenic-antiketogenic’ ratio (Shaffer, 1923) which implied a quantitative relationship between the oxidation of ketone bodies and glucose became widely accepted.

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