acetoacetate in serum/plasma

Reference interval

• < 3 mg/dL (0.3 mmol/L)
• 0.2-2.0 mg/dL (2.0-200 umol/L)

Clinical significance

• in diabetic ketoacidosis (DKA), beta-hydroxybutyrate is the predominant accumulated intermediary metabolite & is a better indicator of clinical state than acetoacetate
• the beta-hydroxybutyrate/acetoactetate ratio is normally 3:1 & will rise to 6-12:1 during ketoacidosis
• plasma acetoacetate may actually rise during therapy for DKA due to conversion of beta-hydroxybutyrate

Increases

• ketoacidosis, diabetic ketoacidosis
• ketosis, starvation, fasting, low carbohydrate diet

Methods

• quantitative enzymatic method

Specimen

• plasma (sodium fluoride)
• collect on ice, deliver to laboratory immediately
• freeze if not assayed upon receipt

More general terms

• acetoacetate in body fluid

More specific terms

• acetoacetate+acetone in serum/plasma

Additional terms

• acetoacetate; beta-ketobutyrate; 3-ketobutyrate
• beta(3)-hydroxybutyrate in blood/plasma/serum
• ketone bodies in serum/plasma