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AcAc is converted in a reversible reaction catalyzed by D--hydroxybutyrate dehydrogenase (BDH1), leading to the formation of BHB, or undergoes non-enzymatic decarboxylation with the formation of acetone (Figure 2) (104, 105)

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Weeks 5 to 8: Reduce from 1.7 mg to 1.0 mg weekly