Ketone body production in diabetic ketosis by other than liver

To determine if ketone bodies, synthesized from fatty acids by tissues other than the liver, enter the circulation, rats in diabetic ketosis were injected with sodium [6,13-14C]palmitate. Hydroxybutyrate was isolated from the urine excreted by each rat and from an aqueous extract of its carcass. The distribution of 14C in the four carbons of hydroxybutyrate in the extract was the same as in the urine. The ratio of 14C in carbon 1 to carbon 3 of the hydroxybutyrate averaged 1.80 and averaged 1.31 in carbon 2 to carbon 4. Hydroxybutyrate when formed by perfused liver has the same carbon 1-to-carbon 3 ratio as carbon 2-to-carbon 4 ratio. The results indicate that hydroxybutyrate synthesized by tissues other than the liver mixes in the circulation with that synthesized by the liver and a portion of the mix is then excreted in the urine. The difference between the carbon 1-to-3 carbon ratio 3 and carbon 2-to-carbon 4 ratio calculates to an estimated minimum of 15% to 17% of the hydroxybutyrate in the circulation of the ketotic diabetic rat having tissues other than the liver as its source. Assuming the liver and kidneys are the sources of the ketone bodies in diabetic ketosis, the ketone bodies produced by the kidneys are not excreted into the urine without first entering the circulation.