In addition to the above targets, in various disease models, ketone bodies can also act on AMPK-FOXO3 (Forkhead box O3), FOXO1 (Bae et al., 2016), PPARγ coactivator 1 alpha (PGC-1α) (Kim et al., 2019), NADPH oxidase 4 (NOX4) (Kanikarla-Marie and Jain, 2015), Akt-mTOR (Li et al., 2017) and the MAPK signaling pathway (Li et al., 2022) to exert anti-inflammatory effects, endoplasmic reticulum stress and other pathophysiological processes, which are closely related to the occurrence and development of heart diseases. The gene discussed is NOX4; the disease is heart disorder.