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. 2020 Feb 25;48(1):51–59. doi: 10.1042/BST20190240

Figure 2. The βHB monoester bond is cleaved by gut esterases, yielding βHB and butanediol, which enter the portal circulation.

Figure 2.

In the liver, alcohol dehydrogenase (ADH) converts butanediol converted into βHB, which leaves via the monocarboxylate transporters (MCT). Each monoester molecule thus yields two βHB equivalents.