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beta-hydroxybutyric acid 3-hydroxybutanoic bhb beta hydroxy hydroxybutyrate enantiomer chiral endogenous gpcr biosynthesis metabolism fatty acids ketogenic amino ketone body acetoacetate ketosis blood glucose diabetic ketoacidosis alcoholic diabetic blood-brain-barrier central nervous system metabolite cycle mechanism pathway path catabolism biosynthetic intermediate biogenesis substrate precursor synthesis derivative bioprecursor metabolic enzyme contractor molecule molecular formula skeletal structural 3d