α-Hydroxybutyrate Is an Early Biomarker of Insulin Resistance and Glucose Intolerance in a Nondiabetic Population
Figure 7
A Model of the biochemical relationship of α-HB biosynthesis and associated metabolic pathways with Insulin Resistance.
α-HB is produced from the conversion of α-KB in a reaction catalyzed by LDH that occurs when the NADH/NAD+ ratio is elevated, as can occur from higher lipid oxidation events. Metabolites that change significantly (screening and targeted data, p<0.01) are indicated by a box; arrows indicate the direction of change. α-HB, alpha-hydroxybutyrate; α-KB, alpha-ketobutyrate; BCAA, branched chain amino acids; BCKDH, branched chain alpha keto acid dehydrogenase; CBS, cystathionine-beta-synthase; CGL, cystathionine gamma-lyase; HBDH, α-hydroxybutyrate dehydrogenase; LDH, lactate dehydrogenase; SAH, S-adenosyl-L-homocysteine; SAM, S-adenosyl Methionine. All compounds in boxes were measured using targeted assays, with the exception of α-KB, cysteine and BCAAs.