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hydroxybutyric acid beta-hydroxybutyric 3-hydroxybutyric bhb 3-hydroxybutanoic acid beta hydroxy chiral enantiomers gpcr biosynthesis acetoacetate ketogenic amino acids metabolism ketone bodies ketosis blood glucose diabetic ketoacidosis alcoholic oxaloacetate endogenous blood-brain-barrier central nervous system metabolite cycle mechanism pathway path catabolism biosynthetic intermediate biogenesis substrate precursor synthesis derivative bioprecursor metabolic enzyme contractor cell biology biochemistry biomolecule bioactive molecule 3d