Sex-Specific Determinants of the Ketone Body β-Hydroxybutyrate in the General Population

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The study analyzed plasma levels of β-hydroxybutyrate (BHB) in 6102 participants from the PREVEND cohort to identify influencing factors.
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Women exhibited significantly higher BHB levels than men, with hormonal status being the primary determinant for women.
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In men, age was the most significant factor affecting BHB levels, with a 1% increase in BHB per year.
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Other determinants of higher BHB levels included lower protein intake, habitual alcohol use, and higher free thyroxine levels.
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The study highlights the importance of considering sex-specific differences when targeting interventions for ketone metabolism.

The Journal Of Clinical Endocrinology & Metabolism

by Martine G E Knol, Amarens van der Vaart, Lyanne Kieneker, Margery A Connelly, Stephan J L Bakker, Roman-Ulrich Müller, Markus M Rinschen, Ron T Gansevoort, Maatje D A van Gastel
October 29, 2025

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