Clinical significance of measurement of serum ketone body levels. Serum 3-hydroxybutyrate (3-OHBA) level as a marker for insulin deficiency.

DOI
  • Kosugi Keisuke
    Department of Medicine, Osaka Police Officer's Hospital
  • Hidaka Hideki
    The 3rd Department of Medicine, Shiga University of Medical Science
  • Aoki Takahiko
    The 3rd Department of Medicine, Shiga University of Medical Science
  • Kojima Hideto
    The 3rd Department of Medicine, Shiga University of Medical Science
  • Nakajima Yuzuru
    The 3rd Department of Medicine, Shiga University of Medical Science
  • Nakamura Takaaki
    The 3rd Department of Medicine, Shiga University of Medical Science
  • Harano Yutaka
    Department of Endocrinology and Metabolism, National Cardiovascular Center Hospital
  • Shigeta Yukio
    The 3rd Department of Medicine, Shiga University of Medical Science

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Other Title
  • 血中ケトン体測定の臨床的意義　インスリン欠乏の指標としての３‐ヒドロキシ酪酸（３‐ＯＨＢＡ）値
  • Serum 3-Hydroxybutyrate (3-OHBA) Level as a Marker for Insulin Deficiency
  • インスリン欠乏の指標としての3-ヒドロキシ酪酸 (3-OHBA) 値

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Differential determination of fasting serum ketone bodies acetoacetate [AcAc], and 3-hydroxybutyrate [3-OHBA] was conducted in 60 insulin dependent diabetes mellitus (IDDM) subjects given conventional insulin treatment and in 208 non-insulin dependent diabetes mellitus (NIDDM) subjects treated with diet or oral hypoglycemic agents in order to evaluate serum ketone body levels as a marker for insulin deficiency. Serum levels of 3-OHBA (557±59 (M±SE)μM) and AcAc (191±27) in IDDM were much higher than those (76±5, 58±2) in NIDDM in spite of a small difference in fasting plasma glucose levels (FPG)(199±11 vs 158±4 mg/dl) in the two groups. An equation which discriminates between IDDM and NIDDM by 3 metabolic factors (FPG, AcAc and 3-OHBA) was obtained as follows:<BR>Z=-3.14-0.31×10-3×(FPG)-0.73×10-2×(AcAc) +1.69×10-2×(3-OHBA)<BR>In this equation, above 0 indicates IDDM, while below 0 indicates NIDDM, with 89% reliability, Serum 3-OHBA levels contribute greatly to the value of this equation and were inversely related to serum free insulin levels. These results indicate that the serum 3-0H BA level is a good metabolic marker for insulin deficiency and suggest that the determination of serum 3-OHBA may be useful in considering the requirement of insulin therapy and the dosage of insulin in diabetic subject.

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