Does hyperketonemia affect protein or glucose kinetics in postabsorptive or traumatized man?

Leucine and glucose turnover were measured using simultaneous infusions of labeled leucine and glucose before and during an infusion of sodium DL-hydroxybutyrate in overnight-fasted patients, the day before and 3 days after total hip replacement. Before surgery, the ketone infusion significantly increased plasma leucine concentration and leucine turnover while glucose concentration and turnover decreased. After surgery, the infusion caused a further increase in leucine turnover while glucose turnover fell as before surgery. The authors suggest exogenous ketone bodies decrease hepatic glucose production and probably stimulate protein synthesis above breakdown.