The Dimer and Trimer of 3-Hydroxybutyrate Oligomer as a Precursor of Ketone Bodies for Nutritional Care

Abstract

Background: Ketone bodies have been considered as a means of providing energy because of their good penetration and rapid diffusion in peripheral tissues. However, because the currently available form of 3-hydroxybutyrate is the sodium salt, the sodium load is problematic. To avoid it, a mixture of dimer and trimer has been prepared as a precursor of D-3-hydroxybutyrate. The purpose of this study was to investigate whether and how the solution would be converted to monomers. Methods: The plasma concentration of 3-hydroxybutyrate monomer was measured in 10 rats during infusion of dimer and trimer. Stepwise dilutions of the solution were incubated with serum and liver homogenates from five rats, serum samples from five volunteers, and a liver sample from one patient with liver injury. The solution also was incubated with carboxylesterase and triacylglycerol lipase. The concentration of monomer in the medium was measured after incubation. Results: The plasma concentration of 3-hydroxybutyrate monomer reached 572 ± 11 μmol/L 15 minutes after beginning infusion of the mixture at a rate of 25 μmol·kg ¹ · min ^-1 and 270 ± 40 μmol/L at a rate of 12.5 μmol · kg^-1· min ¹. The solution was converted completely to monomers when incubated with rat serum or liver homogenate for 10 minutes. The mixture also was hydrolyzed by human liver homogenate but not by serum. Conclusions: The dimer and trimer of 3-hydroxybutyrate can be converted rapidly to monomer in rat and human tissues. 3-Hydroxybutyrate oligomers could be an energy substrate for injured patients. (Journal of Parenteral and Enteral Nutrition 23:321-325, 1999)