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β-Hydroxybutyric acid

β-Hydroxybutyric acid, also known as 3-hydroxybutyric acid or BHB, is an organic compound and a beta hydroxy acid with the chemical formula CH3CH(OH)CH2CO2H; its conjugate base is β-hydroxybutyrate, also known as 3-hydroxybutyrate. β-Hydroxybutyric acid is a chiral compound with two enantiomers: D-β-hydroxybutyric acid and L-β-hydroxybutyric acid. Its oxidized and polymeric derivatives occur widely in nature. In humans, D-β-hydroxybutyric acid is one of two primary endogenous agonists of hydroxycarboxylic acid receptor 2 (HCA2), a Gi/o-coupled G protein-coupled receptor (GPCR).[1][2]

β-Hydroxybutyric acid
Names
Preferred IUPAC name
3-Hydroxybutanoic acid
Identifiers
  • 300-85-6 Y
3D model (JSmol)
  • Interactive image
  • Interactive image
3DMet
  • B00239
773861
ChEBI
  • CHEBI:20067 Y
ChEMBL
  • ChEMBL1162496 Y
ChemSpider
  • 428 Y
ECHA InfoCard 100.005.546
  • 1593
KEGG
  • C01089
MeSH beta-Hydroxybutyrate
  • 441
UNII
  • TZP1275679 Y
  • DTXSID60859511
  • InChI=1S/C4H8O3/c1-3(5)2-4(6)7/h3,5H,2H2,1H3,(H,6,7) Y
    Key: WHBMMWSBFZVSSR-UHFFFAOYSA-N Y
  • InChI=1/C4H8O3/c1-3(5)2-4(6)7/h3,5H,2H2,1H3,(H,6,7)
    Key: WHBMMWSBFZVSSR-UHFFFAOYAO
  • O=C(O)CC(O)C
  • CC(CC(=O)O)O
Properties
C4H8O3
Molar mass 104.105 g·mol−1
Appearance white solid
Melting point 44-46
Related compounds
Other anions
hydroxybutyrate
propionic acid
lactic acid
3-hydroxypropanoic acid
malonic acid
hydroxypentanoic acid
butyric acid
β-methylbutyric acid
β-hydroxy β-methylbutyric acid
Related compounds
erythrose
threose
1,2-butanediol
1,3-butanediol
2,3-butanediol
1,4-butanediol
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
Y verify (what is YN ?)

Biosynthesis edit

In humans, D-β-hydroxybutyrate can be synthesized in the liver via the metabolism of fatty acids (e.g., butyrate), β-hydroxy β-methylbutyrate, and ketogenic amino acids through a series of reactions that metabolize these compounds into acetoacetate, which is the first ketone body that is produced in the fasting state. The biosynthesis of D-β-hydroxybutyrate from acetoacetate is catalyzed by the β-hydroxybutyrate dehydrogenase enzyme.

Butyrate can also be metabolized into D-β-hydroxybutyrate via a second metabolic pathway that does not involve acetoacetate as a metabolic intermediate. This metabolic pathway is as follows:[3]

butyrate→butyryl-CoAcrotonyl-CoAβ-hydroxybutyryl-CoApoly-β-hydroxybutyrateD-β-(D-β-hydroxybutyryloxy)-butyrateD-β-hydroxybutyrate

The last reaction in this metabolic pathway, which involves the conversion of D-β-(D-β-hydroxybutyryloxy)-butyrate into D-β-hydroxybutyrate, is catalyzed by the hydroxybutyrate-dimer hydrolase enzyme.[3]

The concentration of β-hydroxybutyrate in human blood plasma, as with other ketone bodies, increases through ketosis.[4] This elevated β-hydroxybutyrate level is naturally expected, as β-hydroxybutyrate is formed from acetoacetate. The compound can be used as an energy source by the brain and skeletal muscle when blood glucose is low.[5][6][7][8] Diabetic patients can have their ketone levels tested via urine or blood to indicate diabetic ketoacidosis. In alcoholic ketoacidosis, this ketone body is produced in greatest concentration. Ketogenesis occurs if oxaloacetate in the liver cells is depleted, a circumstance created by reduced carbohydrate intake (through diet or starvation); prolonged, excessive alcohol consumption; and/or insulin deficiency. Because oxaloacetate is crucial for entry of acetyl-CoA into the TCA cycle, the rapid production of acetyl-CoA from fatty acid oxidation in the absence of ample oxaloacetate overwhelms the decreased capacity of the TCA cycle, and the resultant excess of acetyl-CoA is shunted towards ketone body production.[citation needed]


Biological activity edit

D-β-Hydroxybutyric acid, along with butyric acid, are the two primary endogenous agonists of hydroxycarboxylic acid receptor 2 (HCA2), a Gi/o-coupled GPCR.[1][2][12]

β-Hydroxybutyric acid is able to cross the blood-brain-barrier into the central nervous system.[13] Levels of β-hydroxybutyric acid increase in the liver, heart, muscle, brain, and other tissues with exercise, calorie restriction, fasting, and ketogenic diets.[13] The compound has been found to act as a histone deacetylase (HDAC) inhibitor.[13] Through inhibition of the HDAC class I isoenzymes HDAC2 and HDAC3, β-hydroxybutyric acid has been found to increase brain-derived neurotrophic factor (BDNF) levels and TrkB signaling in the hippocampus.[13] Moreover, a rodent study found that prolonged exercise increases plasma β-hydroxybutyrate concentrations, which induces promoters of the BDNF gene in the hippocampus.[13] These findings may have clinical relevance in the treatment of depression, anxiety, and cognitive impairment.[13]

In epilepsy patients on the ketogenic diet, blood β-hydroxybutyrate levels correlate best with degree of seizure control. The threshold for optimal anticonvulsant effect appears to be approximately 4 mmol/L.[14]

Laboratory and industrial chemistry edit

β-Hydroxybutyric acid is the precursor to polyesters, which are biodegradable plastics. This polymer, poly(3-hydroxybutyrate), is also naturally produced by the bacteria Alcaligenes eutrophus.[15]

β-Hydroxybutyrate can be extracted from poly(3-hydroxybutyrate) by acid hydrolysis.[16]

The concentration of β-hydroxybutyrate in blood plasma is measured through a test that uses β-hydroxybutyrate dehydrogenase, with NAD+ as an electron-accepting cofactor. The conversion of β-hydroxybutyrate to acetoacetate, which is catalyzed by this enzyme, reduces the NAD+ to NADH, generating an electrical change; the magnitude of this change can then be used to extrapolate the amount of β-hydroxybutyrate in the sample.

See also edit

Notes edit

  1. ^ This reaction is catalyzed by an unknown thioesterase enzyme.[9][10]

References edit

  1. ^ a b Offermanns S, Colletti SL, Lovenberg TW, Semple G, Wise A, IJzerman AP (June 2011). "International Union of Basic and Clinical Pharmacology. LXXXII: Nomenclature and Classification of Hydroxy-carboxylic Acid Receptors (GPR81, GPR109A, and GPR109B)". Pharmacological Reviews. 63 (2): 269–290. doi:10.1124/pr.110.003301. PMID 21454438.
  2. ^ a b Offermanns S, Colletti SL, IJzerman AP, Lovenberg TW, Semple G, Wise A, Waters MG. "Hydroxycarboxylic acid receptors". IUPHAR/BPS Guide to Pharmacology. International Union of Basic and Clinical Pharmacology. Retrieved 13 July 2018.
  3. ^ a b "Butanoate metabolism - Reference pathway". Kyoto Encyclopedia of Genes and Genomes. Kanehisa Laboratories. 1 November 2017. Retrieved 1 February 2018.
  4. ^ Perelas A, Staros EB (October 30, 2015). "Beta-Hydroxybutyrate". Medscape. WebMD LLC. Retrieved February 8, 2017.
  5. ^ Owen OE, Morgan AP, Kemp HG, Sullivan JM, Herrera MG, Cahill GF (October 1967). "Brain metabolism during fasting". The Journal of Clinical Investigation. 46 (10): 1589–1595. doi:10.1172/JCI105650. PMC 292907. PMID 6061736.
  6. ^ Evans E, Walhin JP, Hengist A, Betts JA, Dearlove DJ, Gonzalez JT (January 2023). "Ketone monoester ingestion increases postexercise serum erythropoietin concentrations in healthy men". American Journal of Physiology. Endocrinology and Metabolism. 324 (1): E56–E61. doi:10.1152/ajpendo.00264.2022. PMC 9870573. PMID 36449571.
  7. ^ Cahill GF (2006-08-01). "Fuel metabolism in starvation". Annual Review of Nutrition. 26 (1): 1–22. doi:10.1146/annurev.nutr.26.061505.111258. PMID 16848698.
  8. ^ Mikkelsen KH, Seifert T, Secher NH, Grøndal T, van Hall G (February 2015). "Systemic, cerebral and skeletal muscle ketone body and energy metabolism during acute hyper-D-β-hydroxybutyratemia in post-absorptive healthy males". The Journal of Clinical Endocrinology and Metabolism. 100 (2): 636–643. doi:10.1210/jc.2014-2608. PMID 25415176.
  9. ^ "KEGG Reaction: R10759". Kyoto Encyclopedia of Genes and Genomes. Kanehisa Laboratories. Retrieved 24 June 2016.
  10. ^ Mock DM, Stratton SL, Horvath TD, Bogusiewicz A, Matthews NI, Henrich CL, Dawson AM, Spencer HJ, Owen SN, Boysen G, Moran JH (November 2011). "Urinary excretion of 3-hydroxyisovaleric acid and 3-hydroxyisovaleryl carnitine increases in response to a leucine challenge in marginally biotin-deficient humans". primary source. The Journal of Nutrition. 141 (11): 1925–1930. doi:10.3945/jn.111.146126. PMC 3192457. PMID 21918059. Metabolic impairment diverts methylcrotonyl CoA to 3-hydroxyisovaleryl CoA in a reaction catalyzed by enoyl-CoA hydratase (22, 23). 3-Hydroxyisovaleryl CoA accumulation can inhibit cellular respiration either directly or via effects on the ratios of acyl CoA:free CoA if further metabolism and detoxification of 3-hydroxyisovaleryl CoA does not occur (22). The transfer to carnitine by 4 carnitine acyl-CoA transferases distributed in subcellular compartments likely serves as an important reservoir for acyl moieties (39–41). 3-Hydroxyisovaleryl CoA is likely detoxified by carnitine acetyltransferase producing 3HIA-carnitine, which is transported across the inner mitochondrial membrane (and hence effectively out of the mitochondria) via carnitine-acylcarnitine translocase (39). 3HIA-carnitine is thought to be either directly deacylated by a hydrolase to 3HIA or to undergo a second CoA exchange to again form 3-hydroxyisovaleryl CoA followed by release of 3HIA and free CoA by a thioesterase.
  11. ^ a b "Valine, leucine and isoleucine degradation - Reference pathway". Kyoto Encyclopedia of Genes and Genomes. Kanehisa Laboratories. 27 January 2016. Retrieved 1 February 2018.
  12. ^ a b "β-D-hydroxybutyric acid: Biological activity". IUPHAR/BPS Guide to Pharmacology. International Union of Basic and Clinical Pharmacology. Retrieved 5 February 2018.
  13. ^ a b c d e f Sleiman SF, Henry J, Al-Haddad R, El Hayek L, Abou Haidar E, Stringer T, et al. (June 2016). "Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body β-hydroxybutyrate". eLife. 5. doi:10.7554/eLife.15092. PMC 4915811. PMID 27253067.
  14. ^ Gilbert DL, Pyzik PL, Freeman JM (December 2000). "The ketogenic diet: seizure control correlates better with serum beta-hydroxybutyrate than with urine ketones". Journal of Child Neurology. 15 (12): 787–790. doi:10.1177/088307380001501203. PMID 11198492. S2CID 46659339.
  15. ^ Doi Y, Kunioka M, Nakamura Y, Soga K (1988). "Nuclear magnetic resonance studies on unusual bacterial copolyesters of 3-hydroxybutyrate and 4-hydroxybutyrate". Macromolecules. 21 (9): 2722–2727. Bibcode:1988MaMol..21.2722D. doi:10.1021/ma00187a012.
  16. ^ Seebach D, Beck AK, Breitschuh R, Job K (April 1993). "Direct Degradation of the Biopolymer Poly[(R)-3-Hydroxybutrric Acid to (R)-3-Hydroxybutanoic Acid and Its Methyl Ester". Organic Syntheses. 71: 39. doi:10.15227/orgsyn.071.0039.

hydroxybutyric, acid, confused, with, hydroxy, methylbutyric, acid, also, known, hydroxybutyric, acid, organic, compound, beta, hydroxy, acid, with, chemical, formula, ch3ch, ch2co2h, conjugate, base, hydroxybutyrate, also, known, hydroxybutyrate, chiral, comp. Not to be confused with b Hydroxy b methylbutyric acid b Hydroxybutyric acid also known as 3 hydroxybutyric acid or BHB is an organic compound and a beta hydroxy acid with the chemical formula CH3CH OH CH2CO2H its conjugate base is b hydroxybutyrate also known as 3 hydroxybutyrate b Hydroxybutyric acid is a chiral compound with two enantiomers D b hydroxybutyric acid and L b hydroxybutyric acid Its oxidized and polymeric derivatives occur widely in nature In humans D b hydroxybutyric acid is one of two primary endogenous agonists of hydroxycarboxylic acid receptor 2 HCA2 a Gi o coupled G protein coupled receptor GPCR 1 2 b Hydroxybutyric acid Names Preferred IUPAC name 3 Hydroxybutanoic acid Identifiers CAS Number 300 85 6 Y 3D model JSmol Interactive imageInteractive image 3DMet B00239 Beilstein Reference 773861 ChEBI CHEBI 20067 Y ChEMBL ChEMBL1162496 Y ChemSpider 428 Y ECHA InfoCard 100 005 546 IUPHAR BPS 1593 KEGG C01089 MeSH beta Hydroxybutyrate PubChem CID 441 UNII TZP1275679 Y CompTox Dashboard EPA DTXSID60859511 InChI InChI 1S C4H8O3 c1 3 5 2 4 6 7 h3 5H 2H2 1H3 H 6 7 YKey WHBMMWSBFZVSSR UHFFFAOYSA N YInChI 1 C4H8O3 c1 3 5 2 4 6 7 h3 5H 2H2 1H3 H 6 7 Key WHBMMWSBFZVSSR UHFFFAOYAO SMILES O C O CC O CCC CC O O O Properties Chemical formula C 4H 8O 3 Molar mass 104 105 g mol 1 Appearance white solid Melting point 44 46 Related compounds Other anions hydroxybutyrate Related carboxylic acids propionic acidlactic acid3 hydroxypropanoic acidmalonic acidhydroxypentanoic acidbutyric acidb methylbutyric acidb hydroxy b methylbutyric acid Related compounds erythrosethreose1 2 butanediol1 3 butanediol2 3 butanediol1 4 butanediol Except where otherwise noted data are given for materials in their standard state at 25 C 77 F 100 kPa Y verify what is Y N Infobox references Contents 1 Biosynthesis 2 Biological activity 3 Laboratory and industrial chemistry 4 See also 5 Notes 6 ReferencesBiosynthesis editIn humans D b hydroxybutyrate can be synthesized in the liver via the metabolism of fatty acids e g butyrate b hydroxy b methylbutyrate and ketogenic amino acids through a series of reactions that metabolize these compounds into acetoacetate which is the first ketone body that is produced in the fasting state The biosynthesis of D b hydroxybutyrate from acetoacetate is catalyzed by the b hydroxybutyrate dehydrogenase enzyme Butyrate can also be metabolized into D b hydroxybutyrate via a second metabolic pathway that does not involve acetoacetate as a metabolic intermediate This metabolic pathway is as follows 3 butyrate butyryl CoA crotonyl CoA b hydroxybutyryl CoA poly b hydroxybutyrate D b D b hydroxybutyryloxy butyrate D b hydroxybutyrate The last reaction in this metabolic pathway which involves the conversion of D b D b hydroxybutyryloxy butyrate into D b hydroxybutyrate is catalyzed by the hydroxybutyrate dimer hydrolase enzyme 3 The concentration of b hydroxybutyrate in human blood plasma as with other ketone bodies increases through ketosis 4 This elevated b hydroxybutyrate level is naturally expected as b hydroxybutyrate is formed from acetoacetate The compound can be used as an energy source by the brain and skeletal muscle when blood glucose is low 5 6 7 8 Diabetic patients can have their ketone levels tested via urine or blood to indicate diabetic ketoacidosis In alcoholic ketoacidosis this ketone body is produced in greatest concentration Ketogenesis occurs if oxaloacetate in the liver cells is depleted a circumstance created by reduced carbohydrate intake through diet or starvation prolonged excessive alcohol consumption and or insulin deficiency Because oxaloacetate is crucial for entry of acetyl CoA into the TCA cycle the rapid production of acetyl CoA from fatty acid oxidation in the absence of ample oxaloacetate overwhelms the decreased capacity of the TCA cycle and the resultant excess of acetyl CoA is shunted towards ketone body production citation needed Leucine metabolism in humans nbsp L Leucine Branched chain aminoacid aminotransferase a Ketoglutarate Glutamate Glutamate Alanine Pyruvate Muscle a Ketoisocaproate a KIC Liver a Ketoisocaproate a KIC Branched chain a ketoaciddehydrogenase mitochondria KIC dioxygenase cytosol Isovaleryl CoA b Hydroxyb methylbutyrate HMB Excretedin urine 10 40 HMB CoA b Hydroxy b methylglutaryl CoA HMG CoA b Methylcrotonyl CoA MC CoA b Methylglutaconyl CoA MG CoA CO2 CO2 O2 CO2 H2O CO2 H2O liver HMG CoAlyase Enoyl CoA hydratase Isovaleryl CoAdehydrogenase MC CoAcarboxylase MG CoAhydratase HMG CoAreductase HMG CoA synthase b Hydroxybutyratedehydrogenase Mevalonatepathway Thiolase Unknownenzyme b Hydroxybutyrate Acetoacetyl CoA Acetyl CoA Acetoacetate Mevalonate Cholesterol note 1 nbsp Acetoacetate the metabolic precursor of b hydroxybutyrate is a metabolite of fatty acids ketogenic amino acids such as leucine 11 and isoleucine 11 and b hydroxy b methylbutyrateBiological activity editThis section needs expansion with transporter proteins 12 that move it across lipid membranes You can help by adding to it February 2018 D b Hydroxybutyric acid along with butyric acid are the two primary endogenous agonists of hydroxycarboxylic acid receptor 2 HCA2 a Gi o coupled GPCR 1 2 12 b Hydroxybutyric acid is able to cross the blood brain barrier into the central nervous system 13 Levels of b hydroxybutyric acid increase in the liver heart muscle brain and other tissues with exercise calorie restriction fasting and ketogenic diets 13 The compound has been found to act as a histone deacetylase HDAC inhibitor 13 Through inhibition of the HDAC class I isoenzymes HDAC2 and HDAC3 b hydroxybutyric acid has been found to increase brain derived neurotrophic factor BDNF levels and TrkB signaling in the hippocampus 13 Moreover a rodent study found that prolonged exercise increases plasma b hydroxybutyrate concentrations which induces promoters of the BDNF gene in the hippocampus 13 These findings may have clinical relevance in the treatment of depression anxiety and cognitive impairment 13 In epilepsy patients on the ketogenic diet blood b hydroxybutyrate levels correlate best with degree of seizure control The threshold for optimal anticonvulsant effect appears to be approximately 4 mmol L 14 Laboratory and industrial chemistry editb Hydroxybutyric acid is the precursor to polyesters which are biodegradable plastics This polymer poly 3 hydroxybutyrate is also naturally produced by the bacteria Alcaligenes eutrophus 15 b Hydroxybutyrate can be extracted from poly 3 hydroxybutyrate by acid hydrolysis 16 The concentration of b hydroxybutyrate in blood plasma is measured through a test that uses b hydroxybutyrate dehydrogenase with NAD as an electron accepting cofactor The conversion of b hydroxybutyrate to acetoacetate which is catalyzed by this enzyme reduces the NAD to NADH generating an electrical change the magnitude of this change can then be used to extrapolate the amount of b hydroxybutyrate in the sample See also editGamma Hydroxybutyric acid b Hydroxy b methylbutyric acid HMB Hydroxybutyric acid KetogenesisNotes edit This reaction is catalyzed by an unknown thioesterase enzyme 9 10 References edit a b Offermanns S Colletti SL Lovenberg TW Semple G Wise A IJzerman AP June 2011 International Union of Basic and Clinical Pharmacology LXXXII Nomenclature and Classification of Hydroxy carboxylic Acid Receptors GPR81 GPR109A and GPR109B Pharmacological Reviews 63 2 269 290 doi 10 1124 pr 110 003301 PMID 21454438 a b Offermanns S Colletti SL IJzerman AP Lovenberg TW Semple G Wise A Waters MG Hydroxycarboxylic acid receptors IUPHAR BPS Guide to Pharmacology International Union of Basic and Clinical Pharmacology Retrieved 13 July 2018 a b Butanoate metabolism Reference pathway Kyoto Encyclopedia of Genes and Genomes Kanehisa Laboratories 1 November 2017 Retrieved 1 February 2018 Perelas A Staros EB October 30 2015 Beta Hydroxybutyrate Medscape WebMD LLC Retrieved February 8 2017 Owen OE Morgan AP Kemp HG Sullivan JM Herrera MG Cahill GF October 1967 Brain metabolism during fasting The Journal of Clinical Investigation 46 10 1589 1595 doi 10 1172 JCI105650 PMC 292907 PMID 6061736 Evans E Walhin JP Hengist A Betts JA Dearlove DJ Gonzalez JT January 2023 Ketone monoester ingestion increases postexercise serum erythropoietin concentrations in healthy men American Journal of Physiology Endocrinology and Metabolism 324 1 E56 E61 doi 10 1152 ajpendo 00264 2022 PMC 9870573 PMID 36449571 Cahill GF 2006 08 01 Fuel metabolism in starvation Annual Review of Nutrition 26 1 1 22 doi 10 1146 annurev nutr 26 061505 111258 PMID 16848698 Mikkelsen KH Seifert T Secher NH Grondal T van Hall G February 2015 Systemic cerebral and skeletal muscle ketone body and energy metabolism during acute hyper D b hydroxybutyratemia in post absorptive healthy males The Journal of Clinical Endocrinology and Metabolism 100 2 636 643 doi 10 1210 jc 2014 2608 PMID 25415176 KEGG Reaction R10759 Kyoto Encyclopedia of Genes and Genomes Kanehisa Laboratories Retrieved 24 June 2016 Mock DM Stratton SL Horvath TD Bogusiewicz A Matthews NI Henrich CL Dawson AM Spencer HJ Owen SN Boysen G Moran JH November 2011 Urinary excretion of 3 hydroxyisovaleric acid and 3 hydroxyisovaleryl carnitine increases in response to a leucine challenge in marginally biotin deficient humans primary source The Journal of Nutrition 141 11 1925 1930 doi 10 3945 jn 111 146126 PMC 3192457 PMID 21918059 Metabolic impairment diverts methylcrotonyl CoA to 3 hydroxyisovaleryl CoA in a reaction catalyzed by enoyl CoA hydratase 22 23 3 Hydroxyisovaleryl CoA accumulation can inhibit cellular respiration either directly or via effects on the ratios of acyl CoA free CoA if further metabolism and detoxification of 3 hydroxyisovaleryl CoA does not occur 22 The transfer to carnitine by 4 carnitine acyl CoA transferases distributed in subcellular compartments likely serves as an important reservoir for acyl moieties 39 41 3 Hydroxyisovaleryl CoA is likely detoxified by carnitine acetyltransferase producing 3HIA carnitine which is transported across the inner mitochondrial membrane and hence effectively out of the mitochondria via carnitine acylcarnitine translocase 39 3HIA carnitine is thought to be either directly deacylated by a hydrolase to 3HIA or to undergo a second CoA exchange to again form 3 hydroxyisovaleryl CoA followed by release of 3HIA and free CoA by a thioesterase a b Valine leucine and isoleucine degradation Reference pathway Kyoto Encyclopedia of Genes and Genomes Kanehisa Laboratories 27 January 2016 Retrieved 1 February 2018 a b b D hydroxybutyric acid Biological activity IUPHAR BPS Guide to Pharmacology International Union of Basic and Clinical Pharmacology Retrieved 5 February 2018 a b c d e f Sleiman SF Henry J Al Haddad R El Hayek L Abou Haidar E Stringer T et al June 2016 Exercise promotes the expression of brain derived neurotrophic factor BDNF through the action of the ketone body b hydroxybutyrate eLife 5 doi 10 7554 eLife 15092 PMC 4915811 PMID 27253067 Gilbert DL Pyzik PL Freeman JM December 2000 The ketogenic diet seizure control correlates better with serum beta hydroxybutyrate than with urine ketones Journal of Child Neurology 15 12 787 790 doi 10 1177 088307380001501203 PMID 11198492 S2CID 46659339 Doi Y Kunioka M Nakamura Y Soga K 1988 Nuclear magnetic resonance studies on unusual bacterial copolyesters of 3 hydroxybutyrate and 4 hydroxybutyrate Macromolecules 21 9 2722 2727 Bibcode 1988MaMol 21 2722D doi 10 1021 ma00187a012 Seebach D Beck AK Breitschuh R Job K April 1993 Direct Degradation of the Biopolymer Poly R 3 Hydroxybutrric Acid to R 3 Hydroxybutanoic Acid and Its Methyl Ester Organic Syntheses 71 39 doi 10 15227 orgsyn 071 0039 Retrieved from https en wikipedia org w index php title B Hydroxybutyric acid amp oldid 1194115582, wikipedia, wiki, book, books, library,

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