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Fig. 3


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Simpler beta-oxidation of medium chain fatty acids (MCFA) which, unlike long chain fatty acids (LCFA), do not need to be activated by carnitine to access the inner mitochondrial membrane. Very little acetyl-CoA enters the Krebs’ cycle in the liver since the intermediates, oxaloacetate and malate, are consumed for glucose production. The high amount of NADH also allosterically inhibits the Krebs’ cycle. These mechanisms result in the accumulation of acetyl-CoA in the liver and their subsequent condensation to ketones through a series of enzyme-catalyzed steps.

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