Lab Test: Beta-Hydroxybutyrate (Blood) Level
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- Measurement of beta-hydroxybutyrate in whole blood, serum, or plasma to evaluate ketone-producing metabolic energy deficits that usually occur when there is insufficient carbohydrate metabolism, thereby increasing the catabolism of fatty acids.
- Whole blood, serum or plasma: 0.21 to 2.81 mg/dL (20-270 micromol/L)
- Serum (enzymatic-kinetic technique): <3.02 mg/dL (290 micromol/L)
- Common tests for ketone bodies, such as Acetest, Chemstrip, and Ketostix, do not detect beta-hydroxybutyrate. A handheld meter sensor system is available to monitor beta-hydroxybutyrate and glucose levels.
- Elevated levels beta-hydroxybutyrate is diagnostic of ketoacidosis, whereas the absence of concomitant hyperglycemia supports the diagnosis of alcoholic ketoacidosis (AKA).
- Levels ³ 3 mmol/L are indicative of ketoacidosis. In very severe diabetic ketoacidosis (DKA), the beta-hydroxybutyrate serum concentration may exceed 25 mmol/L.
- Patients presenting with isopropanol intoxication can present with high acetone levels without any acidosis, anion gap or abnormal glucoses levels.
- Plasma (lithium-heparin or fluoride-oxalate), serum, or perchloric acid (PCA) extracts can be analyzed.
- EDTA-plasma samples will produce values that are 60% lower than specimens preserved with fluoride-oxalate or PCA.
- Whole blood specimens are stable at room temperature up to 48 hours.
- Plasma samples are stable at room temperature up to 7 days, 14 days at 4°C, and 6 months at -20°C.
- PCA extracts are stable at -20°C up to 1 year.
- Repeated freeze-thaw cycling has no detrimental effect.
- Foreback CC. Beta-hydroxybutyrate and acetoacetate levels. Am J Clin Pathol 1997;108(5):602-4.
- Porter WH et al. Laboratory and clinical evaluation of assays for beta-hydroxybutyrate. Am J Clin Pathol 1997;107(3):353-8.
- LaGow B et al., eds. PDR Lab Advisor. A Comprehensive Point-of-Care Guide for Over 600 Lab Tests. First ed. Montvale, NJ: Thomson PDR; 2007.
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