Acetoacetyl-CoA Synthetase, a Novel Cytosolic Ketone Body-Utilizing Enzyme that Specifically Activates Acetoacetate to its Coenzyme A Ester

In mammalians, ketone bodies (acetoacetate, D(-)-3-hydroxybutyrate and acetone) are generated mainly in the liver via the 3-hydroxy-3-methylglutaryl-CoA pathway, carried to and utilized in extrahepatic tissues as an energy source during starvation and diabetes in particular due to their overproduction as the consequence of elevated fatty acid oxidation and lowered glucose metabolism. (omitted)