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Can Serum β-Hydroxybutyrate Be Used to Diagnose Diabetic Ketoacidosis?

Sheikh-Ali, Mae ; Karon, Brad S ; Basu, Ananda ; Kudva, Yogish C ; Muller, Lisa A ; Xu, Jia ; Schwenk, W. Frederick ; Miles, John M

Diabetes care, 2008-04, Vol.31 (4), p.643-647 [Periódico revisado por pares]

Alexandria, VA: American Diabetes Association

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Título:
Can Serum β-Hydroxybutyrate Be Used to Diagnose Diabetic Ketoacidosis?
Autor: Sheikh-Ali, Mae ; Karon, Brad S ; Basu, Ananda ; Kudva, Yogish C ; Muller, Lisa A ; Xu, Jia ; Schwenk, W. Frederick ; Miles, John M
Assuntos: 3-Hydroxybutyric Acid - blood ; Adolescent ; Adult ; Bicarbonates - blood ; Biological and medical sciences ; Biomarkers - blood ; Blood Glucose - analysis ; Child ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 2 - blood ; Diabetes. Impaired glucose tolerance ; Diabetic Ketoacidosis - blood ; Diabetic Ketoacidosis - diagnosis ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Humans ; Inpatients ; Ketone Bodies - blood ; Ketone Bodies - urine ; Medical sciences ; Metabolic diseases ; Miscellaneous ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Retrospective Studies ; Sensitivity and Specificity
É parte de: Diabetes care, 2008-04, Vol.31 (4), p.643-647
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: OBJECTIVE:--Current criteria for the diagnosis of diabetic ketoacidosis (DKA) are limited by their nonspecificity (serum bicarbonate [HCO₃] and pH) and qualitative nature (the presence of ketonemia/ketonuria). The present study was undertaken to determine whether quantitative measurement of a ketone body anion could be used to diagnose DKA. RESEARCH DESIGN AND METHODS--A retrospective review of records from hospitalized diabetic patients was undertaken to determine the concentration of serum β-hydroxybutyrate (βOHB) that corresponds to a HCO₃ level of 18 mEq/l, the threshold value for diagnosis in recently published consensus criteria. Simultaneous admission βOHB and HCO₃ values were recorded from 466 encounters, 129 in children and 337 in adults. RESULTS:--A HCO₃ level of 18 mEq/l corresponded with βOHB levels of 3.0 and 3.8 mmol/l in children and adults, respectively. With the use of these threshold βOHB values to define DKA, there was substantial discordance (~>=20%) between βOHB and conventional diagnostic criteria using HCO₃, pH, and glucose. In patients with DKA, there was no correlation between HCO₃ and glucose levels on admission and a significant but weak correlation between βOHB and glucose levels (P < 0.001). CONCLUSIONS:--Where available, serum βOHB levels >=3.0 and >=3.8 mmol/l in children and adults, respectively, in the presence of uncontrolled diabetes can be used to diagnose DKA and may be superior to the serum HCO₃ level for that purpose. The marked variability in the relationship between βOHB and HCO₃ is probably due to the presence of other acid-base disturbances, especially hyperchloremic, nonanion gap acidosis.
Editor: Alexandria, VA: American Diabetes Association
Idioma: Inglês

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Can Serum β-Hydroxybutyrate Be Used to Diagnose Diabetic Ketoacidosis?

Sheikh-Ali, Mae ; Karon, Brad S ; Basu, Ananda ; Kudva, Yogish C ; Muller, Lisa A ; Xu, Jia ; Schwenk, W. Frederick ; Miles, John M

Alexandria, VA: American Diabetes Association

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