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The glycerol pathway is highly favored through an increase in the unidirectional flux of glycerol-3-phosphate synthesis, coupled with a decrease in the consumption of this metabolite, favoring the generation of dihydroxyacetone phosphate, which is consumed through glycolysis to form pyruvate and subsequent energy production

Acetoacetyl-CoA and an additional acetyl-CoA are converted to -hydroxy--methylglutaryl-CoA (HMG-CoA: 3-hydroxy-3-methylglutaryl-CoA) by mitochondrial HMG-CoA synthase (encoded by the HMGCS2 gene), an enzyme found in large amounts only in the liver and intestinal epithelial cells