Acetoacetate (AcAc) is a ketone body primarily produced in the liver under conditions of excessive fatty acid breakdown, including diabetes mellitus leading to diabetic ketoacidosis. An indispensable energy source during times of limited glucose supply, like bHB, acetoacetate synthesis is increased under conditions of fasting, endurance exercise, and malnutrition. 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: 10-200 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.