Clinical Significance

Ketosis is a common feature in acutely ill patients. In subjects suffering from starvation, acute alcohol abuse, or diabetes mellitus, ketosis can result in severe life-threatening metabolic acidosis. The presence and degree of ketosis can be determined by measuring blood levels of B-hydroxybutyrate. 

Ordinarily, B-hydroxybutyrate is the ketoacid present in the greatest amount in serum. It accounts for approximately 75% of the ketone bodies which also contain acetoacetate and acetone. During periods of ketosis, B-hydroxybutyrate increases even more than the other two ketoacids, acetoacetate and acetone, and has been shown to be a better index of ketoacidosis including the detection of subclinical ketosis. 

In diabetics, the measurement of B-hydroxybutyrate as well as the blood glucose is needed for the assessment of the severity of diabetic coma and is essential for the exclusion of hyperosmolar non-ketotic diabetic coma. Moreover, the insulin requirements are often based on the extent of the existing hyperketonemia shown by the blood levels of B-hydroxybutyrate is therefore extremely important in the assessment of ketosis.

_{Source: B-Hydroxybutyrate LiquiColor Procedure No. 2440}