AUTHOR=Mu Hongna , Yang Ruiyue , Wang Siming , Zhang Wenduo , Wang Xinyue , Li Hongxia , Dong Jun , Chen Wenxiang , Yu Xue , Ji Fusui TITLE=Association of Serum β-Hydroxybutyrate and Coronary Artery Disease in an Urban Chinese Population JOURNAL=Frontiers in Nutrition VOLUME=Volume 9 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.828824 DOI=10.3389/fnut.2022.828824 ISSN=2296-861X ABSTRACT=Ketone bodies, including β-hydroxybutyrate, acetoacetate, and acetone, can substitute and alternate with glucose under conditions of fuel/food deficiency. Ketone-body metabolism is increased in a myriad of tissue-metabolism disorders. Perturbations in metabolism are major contributors to coronary artery disease (CAD). We investigated the association of β-hydroxybutyrate with CAD. A total of 2,970 people of Chinese Han ethnicity were enrolled. The Gensini score was calculated for all patients who had positive findings. The serum level of β-hydroxybutyrate and other laboratory parameters were measured. The association of serum level of metabolites with traditionary risk factors and CAD severity were analyzed. β-hydroxybutyrate was found to be associated with some traditional risk factors of CAD and CAD severity, as determined by the Gensini score or number of diseased regions. Moreover, β-hydroxybutyrate was associated with the T3/T1 tertiles of the Gensini score after adjustment for traditional risk factors by multivariable logistic regression analysis. The association of β-hydroxybutyrate with CAD severity was more obvious in females. Taken together, these data suggest that the circulating β-hydroxybutyrate level is independently associated with CAD severity, and that this association is more pronounced in females.