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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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For example, whether mesangial cell ferroptosis contributes to glomerular sclerosis or if endothelial ferroptosis exacerbates renal microvascular dysfunction in DN has not been rigorously characterized