Emerging insights into the role of BDH1 in the pathogenesis of human cancer

β-Hydroxybutyrate dehydrogenase 1 (BDH1) encodes a key enzyme in the metabolism of ketone bodies and plays a critical role in maintaining cellular energy homeostasis. As a member of the short-chain dehydrogenase/reductase (SDR) family, BDH1 catalyzes the reversible conversion of β-hydroxybutyrate (BHB) to acetoacetate (AcAc), a process that is particularly vital during states of metabolic stress, such as fasting or prolonged exercise. Beyond normal physiology, BDH1 functions as a context-dependent metabolic rheostat in human cancers, supporting altered neoplastic energy metabolism and conferring stress resistance. Its dysregulation is associated with tumor microenvironment adaptation, malignant progression, and differential therapeutic responses, positioning BDH1 as both a potential prognostic biomarker and a promising therapeutic target in precision oncology.