Ketone body formation is a three-step process. At the end of the third step, the body produces acetoacetate. Acetoacetate can be reduced to form β-hydroxybutyrate. Acetoacetate can also undergo slow spontaneous decarboxylation to form acetone. These ketone bodies can be used to generate energy.

Ketone bodies utilisation

• β-hydroxybutyrate is first converted to Acetoacetate. This reaction produces the reduced cofactor ___________.
• Acetoacetate then goes through several more steps to ultimately produce two molecules of acetyl CoA which will enter the TCA cycle to help produce ATP through oxidative phosphorylation.