3-Hydroxybutyrate (bHB) is the most abundant ketone body. It is synthesized from acyl-CoA primarily in the liver. Increasing serum/plasma bHB concentrations reflect upregulated fatty acid β-oxidation as well as ketogenic amino acids catabolism in the liver and skeletal muscle to compensate insufficient glucose supply. bHB synthesis is stimulated and serum/plasma levels increase under conditions of fasting, endurance exercise, malnutrition or metabolic disorders including diabetes mellitus. High levels of ketone bodies, like bHB and AcAc, are not only indicators of diabetic hyperglycemia, but also markers of disturbed glucose metabolism in the prediabetic state (2).
Assessment of diabetic ketoacidosis.
Patient/subject: No special precaution.
Matrix: Serum or EDTA plasma.
Volume: Minimum volume is 50 µL, but 200 µL is optimal and allows reanalysis.
Preparation and stability: Probably stable.
Reported values: 20-700 µmol/L
Intraclass correlation coefficient (ICC): na.
1. Midttun, Ø., McCann, A., Aarseth, O., Krokeide, M., Kvalheim, G., Meyer, K., and Ueland, P.M. (2016). Combined measurement of 6 fat-soluble vitamins and 26 water-soluble functional vitamin markers and amino acids in 50 μL of serum or plasma by high-throughput mass spectrometry. Anal Chem 88, 10427-436.
2. Mahendran, Y., Vangipurapu, J., Cederberg, H., Stancáková, A., Pihlajamäki, J., Soininen, P., Kangas, A.J., Paananen, J., Civelek, M., et al. (2013). Association of ketone body levels with hyperglycemia and type 2 diabetes in 9,398 Finnish men. Diabetes 62, 3618-626.