The role of the liver in diabetic keto-acidosis and idiopathic lactic acidosis: a review

Abstract

The primary site of ketone body production is the liver. Hence ketone body accumulation represents either hepatic over-production or peripheral under-utilization. On the other hand, the evidence suggests that net lactate production occurs in the periphery and the main site of lactate uptake is the liver. This implies that peripheral overproduction or hepatic under-utilization is the cause of lactic acidosis. The available experimental data suggest that alterations of metabolic rates within the liver are the usual primary cause of diabetic keto-acidosis and idiopathic lactic acidosis.