The relationship of a high level of serum beta-hydroxybutyrate to cause of death.
To examine the state of ketoacidosis in relation to the cause of death, three kinds of ketone bodies (acetoacetate, beta-hydroxybutyrate and acetone) were measured in postmortem serum. Of 100 autopsy cases, 22 had ketone body increasing pathophysiological conditions, overlapped in some cases, namely a poorly-nourished state (10 cases), alcoholic fatty liver damage (10), diabetes (5) and infectious disease (5). Of the 3, 11, 7 and 15 cases in which the beta-hydroxybutyrate concentration was greater than 10,000, 1000-10,000, 500-1000 and 200-500 micromol/l, 3 (100%), 8 (73%), 3 (43%) and 5 (33%), respectively, had one or more pathophysiological conditions that usually produce ketone bodies. Of the 64 cases in which the beta-hydroxybutyrate concentrations were less than 200 micromol/l, only 3 (5%) had some of these conditions. Cases showing high levels of ketone bodies tended to have pathophysiological states that can produce them, although the level of beta-hydroxybutyrate and these states did not show parallel relationships. When autopsy findings fail to explain the cause of death, a diagnosis as death caused by ketoacidosis would be reasonable if the serum beta-hydroxybutyrate level is over 1000 micromol/l and the body has pathophysiological conditions that tend to increase ketone bodies.
Kanetake
Jun
J
Division of Forensic Medicine, Department of Public Health and Forensic Medicine, Tohoku University School of Medicine, Seiryo-machi 2-1, Sendai 980-8575, Japan.
Kanawaku
Yoshimasa
Y
Mimasaka
Sohtaro
S
Sakai
Jun
J
Hashiyada
Masaki
M
Nata
Masayuki
M
Funayama
Masato
M
D020155:3-Hydroxybutyric Acid / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003920:Diabetes Mellitus / Q000097:blood; D005235:Fatty Liver, Alcoholic / Q000097:blood; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D007239:Infections / Q000097:blood; D007657:Ketone Bodies / Q000097:blood*; D008297:Male; D044342:Malnutrition / Q000097:blood; D008875:Middle Aged
D007657:Ketone Bodies; D020155:3-Hydroxybutyric Acid