Rise of ketone bodies with psychosocial stress in normal weight men

Kubera, Britta; Hubold, Christian; Wischnath, Hannah; Zug, Sophia; Peters, Achim

doi:10.1016/j.psyneuen.2014.03.008

Cited by 18 publications

(15 citation statements)

References 30 publications

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“…From there, ketones are transported via the systemic circulation toward the brain, where they enhance cerebral energy supply. In fact, experimentally-induced psychosocial stress increased concentrations of serum ␤-hydroxybutyrate by more than 400% (Kubera et al, 2014).…”

Section: Visceral Fat Accumulationmentioning

confidence: 97%

“…Experimental evidence shows that corpulent subjects react to a mental and psychosocial stress test in a low reactive manner (Jones et al, 2012;Kubera et al, 2012). When compared to lean subjects, the subjects with a high body mass displayed low cortisol reactivity to both an acute mental challenge and to a subsequent meal, displayed smaller changes in the vigilant state, less pronounced post-stress-neuroglycopenic states, less pronounced rises in serum ketone concentrations, and showed less 'cerebral insulin suppression' during a meal (Jones et al, 2012;Kubera et al, 2012Kubera et al, , 2014. Moreover, the corpulent subjects showed less anxiety, less uneasiness, less physical malaise and less sadness during the psychosocial challenge .…”

Section: Body Mass Gainmentioning

confidence: 99%

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Stress habituation, body shape and cardiovascular mortality

Peters

McEwen

2015

Neuroscience & Biobehavioral Reviews

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117

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High cardiovascular mortality is well documented in lean phenotypes exhibiting visceral fat accumulation. In contrast, corpulent phenotypes with predominantly subcutaneous fat accumulation display a surprisingly low mortality. The term 'obesity paradox' reflects the difficulty in understanding the biological mechanisms underlying these clinical observations. The allostatic load model of chronic stress focuses on glucocorticoid dysregulation as part of a 'network of allostasis' involving autonomic, endocrine, metabolic, and immune mediators. Here, we expand upon the energetic demands of the brain and show that 'habituators' and 'non-habituators' develop divergent patterns of fat distribution. Central to this process is the recurrent rise in the cerebral energy need (arousal) that non-habituators experience during chronic stress. These neuroenergetic alterations promote visceral fat accumulation, subcutaneous fat loss, and atherogenesis with subsequent cardiovascular events. Habituators are more or less protected against such cardiovascular complications, but there is a metabolic trade-off that we shall discuss in the present paper.

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Section: Visceral Fat Accumulationmentioning

confidence: 97%

Section: Body Mass Gainmentioning

confidence: 99%

Stress habituation, body shape and cardiovascular mortality

Peters

McEwen

2015

Neuroscience & Biobehavioral Reviews

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117

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“…Beside the well-known effect of catecholamines on lipolysis, and the secondary rise in KB production, it has been shown that stressor situations may increase KB by more than 400% [34]: this increase, observed in normal weight subjects, was associated with a surge in ACTH, norepinephrine and epinephrine concentrations, which unfortunately we were unable to assess. Also fasting is a well-known condition characterized by a progressive increase in circulating KB concentration [35]; the co-existence of both stress and prolonged fasting, probably in combination with the state of insulin resistance of T2DM patients, leads to higher 3BOHB levels in this group of subjects.…”

Section: Discussionmentioning

confidence: 89%

The role of point-of-care 3-hydroxybutyrate testing in patients with type 2 diabetes undergoing coronary angiography

Kreutzenberg

Avogaro

2017

J Endocrinol Invest

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PurposeKetone bodies, 3-hydroxybutyrate (3BOHB), and acetoacetate derive from increased free fatty acid beta-oxidation, thus reflecting marked insulin deprivation with or without decompensated diabetes. Objectives of this study were (1) to determine circulating levels of 3BOHB in patients with and without type 2 diabetes (T2DM), before and after an elective coronary angiography; (2) to detect 3BOHB modification during the procedure; (3) to study possible associations between 3BOHB and clinical parameters/outcomes.MethodsSixteen T2DM (72 ± 11 years) and 22 matched controls (71 ± 12 years) undergoing elective coronary angiography were enrolled. In all subjects, biohumoral parameters were determined at hospital admission. Point-of-care determinations of 3BOHB, glucose, and creatinine were performed, at 7 a.m, immediately before and after the procedure. The duration of the fasting period and of the procedure was recorded.ResultsT2DM had significantly higher fasting (0.538 ± 0.320 vs 0.255 ± 0.197 mM/l; p = 0.005) and pre-procedural (0.725 ± 0.429 vs 0.314 ± 0.205; p = 0.002) 3BOHB concentrations than controls. Similarly, absolute increment of 3BOHB from the morning value was significantly greater in T2DM (0.369 ± 0.252 vs 0.127 ± 0.135 in controls; p = 0.002). Significant correlations were observed between pre-procedure 3BOHB and glucose levels (r = 0.586; p < 0.0001) and between pre-procedure 3BOHB and fasting creatinine concentrations (r = 0.364; p = 0.029).ConclusionsAn overnight fasting period and a concomitantly stressful condition induce inappropriate 3BOHB increase in T2DM. Point-of-care capillary 3BOHB may be useful before any procedural/surgical intervention in these patients.

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“…The second brain-pull mechanism is that SNS and HPA increase muscular proteolysis and hepatic gluconeogenesis, procuring the brain with even more glucose (Zhang et al, 2018 ). The third brain-pull mechanism is that SNS and HPA axis increase visceral lipolysis and hepatic ketogenesis, providing ketones as alternative brain substrate (Kubera et al, 2014 ). Indeed, it has been shown that brain ischemia via SNS activation induces the formation of ß-hydroxybutyrate (ketogenesis) in the liver and the consumption of ß-hydroxybutyrate in the brain (Koch et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Proximal Disruption of Brain Energy Supply Raises Systemic Blood Glucose: A Systematic Review

2021

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This work joins a series that methodically tests the predictions of the Selfish-Brain theory. The theory postulates a vital ability of the mammalian brain, namely to give priority to its own energy metabolism. The brain behaves “selfishly” in this respect. For the cerebral artery occlusion studied here, the theory predicts an increase in blood glucose concentration, what becomes the hypothesis to be tested. We conducted a systematic review of cerebral-artery-occlusion papers to test whether or not the included studies could confirm this hypothesis. We identified 239 records, screened 231 works by title or abstract, and analyzed 89 by full text. According to strict selection criteria (set out in our PROSPERO preregistration, complying with PRISMA guidelines), 7 papers provided enough information to decide on the hypothesis. Our hypothesis could be fully confirmed for the 3 to 24 h after the onset of a transient 2 h or permanent occlusion. As for the mechanism, the theory predicts that the energy-deprived brain suppresses insulin secretion via the sympathoadrenal system, thereby preventing insulin-mediated glucose uptake into muscle and fat and, as a result, enhancing insulin-independent glucose uptake via the blood-brain barrier. Evidence from our included studies actually demonstrated cerebral insulin suppression. In all, the current work confirms the second major prediction of the Selfish-Brain theory that relates to a proximal bottleneck of the cerebral supply chain, cerebral artery occlusion. Its first major prediction relates to a distal supply bottleneck, caloric restriction, and is fulfilled as shown by our previous work, whereas the prediction of the long held gluco-lipostatic theory, which sees the brain as only passively supplied, is violated (Sprengell et al., 2021). The crucial point was that caloric restriction elicits smaller changes in mass (energy) in the brain than in the body. Taken together, the evidence from the current and previous work clearly shows that the most accurate predictions are possible with a theory that views the brain as an independently self-regulating energy compartment occupying a primary position in energy metabolism.

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Rise of ketone bodies with psychosocial stress in normal weight men

Cited by 18 publications

References 30 publications

Stress habituation, body shape and cardiovascular mortality

Stress habituation, body shape and cardiovascular mortality

The role of point-of-care 3-hydroxybutyrate testing in patients with type 2 diabetes undergoing coronary angiography

Proximal Disruption of Brain Energy Supply Raises Systemic Blood Glucose: A Systematic Review

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