Mitochondrial HMG-CoA synthase (HMGCS2)
Cofactors used
Clinical / pharmacological. Rate-limiting for ketogenesis; induced by fasting/PPAR-alpha
What it does, reaction by reaction
Ketogenesis Lipid Metabolism · Liver mitochondrial matrix
Acetoacetyl-CoA + acetyl-CoA + H2O → 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) + CoA-SH
Converts Acetoacetyl-CoA Acetyl-CoA H2O into 3-Hydroxy-3-methylglutaryl-CoA (HMG-CoA) CoA-SH
› Notes
Mitochondrial HMG-CoA synthase (HMGCS2) catalyzes this condensation. It is the rate-limiting and committed step of ketogenesis; it is distinct from cytosolic HMG-CoA synthase used in cholesterol synthesis.
Showing all 1 reactions.
What accelerates and inhibits it
Regulation is pathway-specific, so each context is listed separately
Ketogenesis
High acetyl-CoA from β-oxidation; PPARα-mediated expression; fasting
High insulin/carbohydrate availability; low fatty-acid delivery
Glucagon and low insulin induce expression indirectly through fasting transcriptional programs; insulin suppresses ketogenesis
Recent literature
Europe PMC · fetched just now · sorted by publication date
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Hepatocyte SLC31A1-dependent copper accumulation contributes to hepatic glucose and lipid metabolic disturbances through AMPKα1 inactivation.
Cheng YQ, Wei M, Yang L, Zhuang YY, Lu QB. · 2026-09-11
open access unreviewed -
3
Lactate induces renal lipid accumulation and aggravates renal fibrosis by inhibiting the PPARα signaling pathway and fatty acid oxidation.
Wang W, Gao Y, Chen Y, Cheng M, Wei L, Sang Y, Zhang L, Dai R, Wang Y. · 2026-03-10
open access unreviewed -
4
Targeting mitochondrial quality control in diabetic kidney disease: emerging therapeutic opportunities.
Luo J, Lu F, Cuciureanu M, Xu X, Dong H, Gong M. · 2026-02-03
cited 2× open access unreviewed -
5
Research progress in metabolic reprogramming and targeting metabolic pathways for clear cell renal cell carcinoma.
Yao JT, Hu PC, Li XW, Xu JC, Wang KJ, Ye SZ, Meng XY, Chen HC, Liang Y, Ma Q. · 2025-12-19
open access unreviewed -
6
Sotagliflozin Reprograms Hepatic Lipid Metabolism and Attenuates Atherosclerosis Beyond Empagliflozin in CKM Mice
· 2026-10-01
open access unreviewed -
7
Extracts of okra mucilage protect intestinal homeostasis through gut microbiota and immune responses.
Qing M, Sun B, Li Y, Meng Z, Lu Q, Li K, Chen G. · 2026-10-05
unreviewed -
8
Kidney Epithelial AKT Controls Potassium Homeostasis and Metabolic Adaptation.
Inoue MK, Zhang Y, Rivera AV, Hasenour CM, Arroyo JP, Bock F, Yu A, Kaji I, Ferdaus MZ, Delpire E, Young JD, … · 2026-10-01
unreviewed -
9
Proteomic Signatures of Noise-Induced Hearing Loss in the Mouse Cochlea.
Batissoco AC, Alencar-Coutinho D, Ferreira-Scatone AC, Diogo-Cavassana S, Oiticica J, Lezirovitz K, Bento RF. · 2026-10-01
open access unreviewed -
10
Assessing clinical relevance of off-target effects observed at suprapharmacological concentrations of SGLT2 inhibitors. Reply.
Abdualkader AM, Al Batran R. · 2026-10-01
cited 1× open access unreviewed
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