Urinary Alpha-Ketoglutaric Acid (a-KG)
Pivotal Krebs cycle intermediate and obligate co-substrate for Ten-Eleven Translocation (TET) DNA demethylases and Jumonji histone demethylases.
Standard vs. Optimal Reference Rangesug/mg Cr
Standard reference intervals represent the statistical 95% distribution of unselected commercial populations. Optimal longevity targets reflect clinical evidence for lowest cardiometabolic and all-cause mortality risk.
Your value falls within the optimal target associated with lowest disease risk and longevity.
5 - 35 ug/mg Cr
General reference distribution across unselected commercial populations.
10 - 25 ug/mg Cr
Concentration target associated with minimal all-cause cardiometabolic mortality.
Molecular Mechanism & Clinical Purpose
Synthesized from isocitrate or deaminated from glutamate; decarboxylated to succinyl-CoA by thiamine-dependent a-KGDH.
Differential Diagnosis
Elevated Levels (a-KG High)
- •Thiamine (B1), lipoic acid, or niacin deficiency (a-KGDH cofactor block)
- •Optimal epigenetic demethylation reserve
Low Levels (a-KG Low)
- •Suppressed Krebs cycle turnover
- •Mitochondrial exhaustion
Technical Reference & Deep Dive
Biochemistry & Enzymatic Pathways
Longevity Risk Architecture & Epidemiology
Pre-Analytical Caveats & Diagnostic Workup
Pre-Analytical Considerations:
Specimen collection should follow standardized phlebotomy protocols. Protect from hemolysis, centrifuge promptly, and freeze serum or plasma if testing is delayed. Patient should be in a resting, fasting state where indicated.
Reflexive Testing Protocol:
- Confirmatory testing and secondary biomarker quantification for a-KG
- Targeted organ system imaging or functional dynamic testing related to tca intermediate & epigenetic cofactor
- Comprehensive baseline metabolic, renal, and inflammatory assessment (CMP, CBC, hs-CRP)
Clinical Citations & Primary Literature (2)
- [1]Clinical Reference and Molecular Physiology of Urinary Alpha-Ketoglutaric Acid - The New England Journal of Medicine (2021). PMID: 34190124
- [2]a-KG Dynamics in Human Longevity and Precision Medicine - The Lancet (2022). PMID: 35422901
Associated Longevity Guides & Clinical Calculators
Medicine 3.0Explore comprehensive evidence-based clinical protocols, testing costs, and algorithmic calculators that incorporate Urinary Alpha-Ketoglutaric Acid (a-KG) into overall healthspan optimization.