Capillary blood tests may overestimate ketosis: triangulation between three different measures of β-hydroxybutyrate
| Autor: | Ingemar Kåreholt, Staffan Rosenborg, Anna Sandebring-Matton, Ulrika Akenine, Shireen Sindi, Jakob Norgren, Tiia Ngandu, Miia Kivipelto, Karin Nordin |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Physiology Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Beta hydroxybutyrate Physiology (medical) Internal medicine medicine Humans Whole blood Hematologic Tests 3-Hydroxybutyric Acid business.industry Fatty Acids Reproducibility of Results Ketosis Ketones medicine.disease Healthy Volunteers Capillaries Endocrinology Method comparison Ketone bodies Female Diet Ketogenic business 030217 neurology & neurosurgery |
| Zdroj: | American Journal of Physiology-Endocrinology and Metabolism. 318:E184-E188 |
| ISSN: | 1522-1555 0193-1849 |
| Popis: | The ketone body β-hydroxybutyrate (BHB), assessed by a point-of-care meter in venous whole blood (BHBv), was used as the main outcome in a study on nutritional ketosis in healthy older adults. Two other BHB measures were also used in the study for validation and exploratory purposes, and here we report findings on correlation and agreement between those three methods. Ketosis in the range of 0–1.5 mmol/L was induced in 15 healthy volunteers by intake of medium-chain fatty acids after a 12-h fast. BHBv was assessed at 12 time points for 4 h. The same point-of-care meter was also used to test capillary blood (BHBc) at three time points, and a laboratory test determined total ketones (TK) in plasma (BHBp + acetoacetate) at four time points. A total of 180 cases included simultaneous data on BHBv, BHBc, BHBp, and TK. TK correlated with BHBp (Pearson’s r = 0.99), BHBv ( r = 0.91), and BHBc ( r = 0.91), all P < 0.0001. BHBv and BHBp had good agreement in absolute values. However, the slope between BHBc and BHBv, measured with the same device, was in the range of 0.64–0.78 in different regression models, indicating substantially higher BHB concentrations in capillary versus venous blood. We conclude that all three methods are valid to detect relative changes in ketosis, but our results highlight the importance of method considerations and the possible need to adjust cutoffs, e.g., in the management of ketoacidosis and in the evaluation and comparison of dietary interventions. |
| Databáze: | OpenAIRE |
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