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OXCT1 gene
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Gene

OXCT1 gene

The OXCT1 gene provides instructions for an enzyme that helps the body break down ketones for energy during periods of fasting or increased demand.

Normal Function

The OXCT1 gene provides instructions for making an enzyme called succinyl-CoA:3-ketoacid CoA transferase, often abbreviated as SCOT. This enzyme is produced in the mitochondria of cells.

SCOT plays a role in the breakdown of ketones, which are molecules produced by the liver during the breakdown of fats. Ketones serve as an important energy source during prolonged fasting or when energy demands are high, such as during illness or exercise. The SCOT enzyme processes ketones by converting the molecule acetoacetate to acetoacetyl-CoA.

Health Conditions Related to Genetic Changes

Succinyl-CoA:3-ketoacid CoA transferase deficiency

At least 20 mutations in the OXCT1 gene have been found to cause SCOT deficiency. This condition is characterized by episodes of extreme tiredness, appetite loss, and seizures, known as ketoacidotic attacks.

Most OXCT1 mutations result in an enzyme with little or no function. A reduction in functional enzyme leads to an inability to break down ketones, resulting in decreased energy production and elevated levels of ketones in the blood. If these signs become severe, a ketoacidotic attack can occur.

Other Names for This Gene

  • 3-oxoacid CoA transferase 1
  • 3-oxoacid-CoA transferase 1
  • OXCT
  • SCOT
  • SCOT1_HUMAN
  • somatic-type succinyl CoA:3-oxoacid CoA-transferase
  • somatic-type succinyl-CoA:3-oxoacid-CoA-transferase
  • succinyl CoA:3-oxoacid CoA transferase
  • succinyl-CoA:3-ketoacid-CoA transferase
  • succinyl-CoA:3-ketoacid-coenzyme A transferase 1, mitochondrial

Frequently Asked Questions

Early signs include sudden fatigue, vomiting, abdominal pain, rapid breathing, and altered mental status. Laboratory tests will show high blood ketone levels with normal or low glucose. If symptoms progress to confusion, seizures, or severe dehydration, immediate emergency care is required to correct metabolic acidosis and prevent coma.
Diagnosis is made by measuring elevated plasma/urine ketones with normal glucose, combined with genetic testing for pathogenic OXCT1 variants. Enzyme activity can be assessed in cultured fibroblasts or lymphocytes, but genetic confirmation is the definitive test and can be performed even when the patient is asymptomatic.
balanced diet that avoids prolonged fasting and limits excessive fat intake is key. Frequent meals with complex carbohydrates, adequate protein, and moderate healthy fats help maintain glucose availability. During illness, a “sick‑day” plan—providing extra carbohydrates (e.g., glucose polymer solutions) and avoiding catabolic stress—reduces the risk of ketone buildup.
SCOT deficiency is inherited in an autosomal‑recessive manner. Both parents are typically carriers, and each sibling has a 25 % chance of being affected, a 50 % chance of being a carrier, and a 25 % chance of being unaffected and not a carrier. Carrier testing and prenatal or pre‑implantation genetic diagnosis are options for families with a known pathogenic variant.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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