ArticleThe Journal of clinical endocrinology and metabolism2026
Sex-Specific Determinants of the Ketone Body β-Hydroxybutyrate in the General Population.
Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Intermittent Fasting Enhances Genome Integrity and Cytoprotective Pathways via (BHB) β-Hydroxybutyrate Signaling and Chromatin Remodeling.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Article
- Sex-Specific Determinants of the Ketone Body β-Hydroxybutyrate in the General Population.The Journal of clinical endocrinology and metabolism · 2026Article
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Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
contextBeing in a state of ketosis has been associated with numerous positive health outcomes and is currently studied in various medical fields. However, the influence of factors other than diet on ketone body levels in the general population has not yet been investigated.
objectiveThis study aimed to investigate factors that are associated with plasma levels of the ketone body β-hydroxybutyrate (BHB) levels in a general population cohort.
methodsWe included 6102 participants with available plasma BHB data from the Prevention of Renal and Vascular End-stage Disease (PREVEND) population-based cohort study. Fasting plasma BHB was measured using nuclear magnetic resonance spectroscopy. Determinants of BHB concentrations were identified using univariable and stepwise backward regression analyses.
resultsWomen had significantly higher BHB levels than men (123 [interquartile range (IQR) 94-175] vs 119 [IQR 92-164] µmol/L, respectively; P < .001). In women, hormonal status was the most significant determinant of BHB levels. In a multivariable-adjusted model, oral contraceptive (OC) use was associated with a 45% increase in BHB concentration, whereas postmenopausal status was associated with an 11% decrease compared to premenopausal women without OC use. In men, age was the most significant determinant, with a 1% increase in BHB levels per year. In both sexes, other determinants of higher BHB levels were lower protein intake, habitual alcohol use, higher N-terminal pro-B-type natriuretic peptide, and a higher free thyroxine level.
conclusionA complex interplay of metabolic, hormonal, and lifestyle factors are associated with BHB levels in the general population, with distinct sex differences. In women, hormonal status was the most important factor, while in men increasing age was the most significant factor affecting BHB levels.
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