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The test does not measure beta-hydroxybutyric acid and it is only weakly sensitive to acetone when glycine is added to the reaction.
Ketone bodies that commonly appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid.
The term ketones or ketone bodies in reality refers to three intermediate products in the metabolism of fatty acids; acetone, acetoacetic acid and beta-hydroxybutyric acid.
Common nonvolatile acids in humans are lactic acid, phosphoric acid, sulfuric acid, acetoacetic acid, and beta-hydroxybutyric acid.
When ketone bodies are measured by way of urine concentration, acetoacetic acid, along with beta-hydroxybutyric acid (BHB), and acetone, is what is detected.
The three endogenous ketone bodies are acetone, acetoacetic acid, and beta-hydroxybutyric acid, although beta-hydroxybutyric acid is not technically a ketone but a carboxylic acid.
Acetoacetyl-CoA thiolase (also called thiolase II) is specific for the thiolysis of acetoacetyl-CoA and involved in biosynthetic pathways such as poly beta-hydroxybutyric acid synthesis or steroid biogenesis.
The three ketone compounds appear in different proportions in the urine, although these proportions are relatively constant in different samples as both the acetone and the beta-hydroxybutyric acid are produced from the acetoacetic acid.
Fiber, especially cellulose and hemi-cellulose, is primarily broken down into the three volatile fatty acids (VFAs), acetic acid, propanoic acid and beta-hydroxybutyric acid, in these chambers by microbes (mostly bacteria and well as some protozoa, fungi and yeast).
Both acetoacetic acid and beta-hydroxybutyric acid are acidic, and, if levels of these ketone bodies are too high, the pH of the blood drops, resulting in ketoacidosis, a complication of untreated Type I diabetes, and sometimes in Type II (see diabetic ketoacidosis).