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Ketone bodies like beta-hydroxybutyrate and acetoacetate are an alternative source of energy in states of prolonged starvation. Ketone body synthesis occurs in the liver in physiologic states like prolonged fasting or exercise, as well as in pathological states like type 1 diabetes mellitus or alcoholism. Once synthesized, ketone bodies can leave the liver, and enter into peripheral cells such as the brain, skeletal muscle and kidney to serve as energy sources.
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