You Can Get There From Here: Acetone, Anionic Ketones and Even-Carbon Fatty Acids can Provide Substrates for Gluconeogenesis

Although the literature contains studies published more than 30 years ago showing that acetone is not metabolically inert, it is common to find biochemistry textbooks and current research publications asserting that acetone is a ‘dead-end’ metabolite. In fact, acetone derived from the non-enzymatic breakdown of acetoacetate in ketotic individuals or from the oxidation of ingested isopropanol can be metabolized to D-lactate and pyruvate, and ultimately glucose. This report describes the reactions and pathways that account for the metabolism of acetone in humans.