He · Heliyon 2023 · narrative review · n=?

β-Hydroxybutyrate as an epigenetic modifier: Underlying mechanisms and implications.

Level 5 - mechanism / opinion, no new human data

Narrative review summarizing biological mechanisms and preclinical literature without original human data.

PubMed 37928021 · doi:10.1016/j.heliyon.2023.e21098 · record verified 2026-08-26

What was done

This narrative review synthesized literature on the metabolic processes and epigenetic regulatory functions of β-hydroxybutyrate (BHB). It examined BHB-mediated histone post-translational modifications (including β-hydroxybutyrylation, acetylation, and methylation), DNA methylation, and microRNA regulation across cardiovascular diseases, diabetes, neuropsychiatric diseases, cancer, osteoporosis, liver and kidney injury, embryonic development, and intestinal homeostasis.

What was found

The abstract reports no numerical results, effect sizes, or counts of reviewed studies. It qualitatively describes that BHB functions as a signaling molecule and substrate interacting with histone deacetylases and G protein-coupled receptors to mediate anti-oxidative, anti-inflammatory, and cardioprotective pathways through epigenetic gene regulation.

Why it matters

The paper highlights the expanding paradigm that ketone bodies actively alter gene expression and cellular phenotype rather than serving solely as metabolic fuel.

Limits

The paper is a non-systematic narrative review providing no primary quantitative data or study selection methodology. Clinical relevance, effective dosing, and specific outcomes in human disease contexts are not quantified.

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