[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Biochemistry](https://durgical.com/en/biochemistry/) › β-Hydroxybutyrate dehydrogenase (BDH1)

[Biochemistry](https://durgical.com/en/biochemistry/) · Enzyme

# β-Hydroxybutyrate dehydrogenase (BDH1)

This enzyme turns acetoacetate into β-hydroxybutyrate in the liver, and back again in tissues that burn ketones.

Updated 2026-11-01

## Key facts

- Acetoacetate + NADH ⇌ D-β-hydroxybutyrate + NAD⁺; reversible.
- Sits on the inner mitochondrial membrane and needs phosphatidylcholine to work.
- The β-hydroxybutyrate/acetoacetate ratio mirrors mitochondrial NADH/NAD⁺ (normally about 3:1).

**Also called**
D-3-hydroxybutyrate dehydrogenase

**EC number**
[1.1.1.30](https://www.enzyme-database.org/query.php?ec=1.1.1.30)

**Genes**
BDH1

## Regulation

- No major allosteric control: it follows the redox state (NADH/NAD⁺).
- Alcohol and hypoxia raise NADH and shift towards β-hydroxybutyrate.

## Inhibitors and toxins

- No inhibitors in clinical use

## Clinical notes

- In diabetic and alcoholic ketoacidosis the ratio climbs to 10:1, and the nitroprusside strip (which measures acetoacetate) underestimates ketones.
- During ketoacidosis treatment β-hydroxybutyrate turns back into acetoacetate and the strip can look more positive even as the patient improves.

## Pathways

- [Ketogenesis (ketone body synthesis)](https://durgical.com/en/biochemistry/pathways/ketogenesis/)

## Related conditions

- [Diabetic ketoacidosis](https://durgical.com/en/conditions/diabetic-ketoacidosis/)

## Related

- [Acetoacetate (acetoacetic acid)](https://durgical.com/en/biochemistry/molecules/acetoacetate/)
- [β-Hydroxybutyrate](https://durgical.com/en/biochemistry/molecules/hydroxybutyrate/)
- [NAD⁺ (nicotinamide adenine dinucleotide)](https://durgical.com/en/biochemistry/molecules/nad/)
- [Succinyl-CoA:3-ketoacid CoA transferase (SCOT)](https://durgical.com/en/biochemistry/enzymes/succinyl-coa-3-ketoacid-coa-transferase/)

## Test yourself

Think of the answer, then tap the question to see it.

## What sets the ratio of β-hydroxybutyrate to acetoacetate?

The mitochondrial NADH/NAD⁺ ratio, because the reaction is reversible and near equilibrium.

## Why can the urine strip become more positive while ketoacidosis is being treated?

β-Hydroxybutyrate, which the strip misses, is converted back into acetoacetate, which it detects.

## Which membrane lipid does β-hydroxybutyrate dehydrogenase need?

Phosphatidylcholine of the inner mitochondrial membrane.

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Educational information, not medical advice. For any symptom, see a health professional.

Sources: [BDH1: D-beta-hydroxybutyrate dehydrogenase, mitochondrial (human)](https://www.uniprot.org/uniprotkb/Q02338/entry) (UniProt, 2026); [Synthesis of Ketone Bodies](https://reactome.org/PathwayBrowser/#/R-HSA-77111) (Reactome, 2026); [Utilization of Ketone Bodies](https://reactome.org/PathwayBrowser/#/R-HSA-77108) (Reactome, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/biochemistry/enzymes/hydroxybutyrate-dehydrogenase/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/biochemistry/enzymes/hydroxybutyrate-dehydrogenase/