title: Blood, urine and vitreous isopropyl alcohol as biochemical markers in forensic investigations.
abstract: Isopropyl alcohol (IPA) is widely used as an industrial solvent and cleaning fluid. After ingestion or absorption, IPA is converted into acetone by alcohol dehydrogenase. However, in ketosis, acetone can be reduced to IPA. The aim of this study was to investigate blood IPA and acetone concentrations in a series of 400 medico-legal autopsies, including cases of diabetic ketoacidosis, hypothermia and alcohol misuse-related deaths, to illustrate the extent of ketosis at the time of death. Vitreous glucose, blood 3-β-hydroxybutyrate (3HB) and acetoacetate (AcAc) concentrations were also determined systematically. Additionally, vitreous and urine IPA, acetone, 3HB and AcAc concentrations as well as other biochemical markers, including glycated hemoglobin and carbohydrate-deficient transferrin (CDT) were also determined in selected cases. The results of this study indicate that ketosis is characterized by the presence of IPA resulting from the acetone metabolism and that IPA can be detected in several substrates. These findings confirm the importance of the systematic determination of IPA and acetone levels that is used to quantify biochemical disturbances and the importance of ketosis at the time of death.
authors.affiliation: University Center of Legal Medicine, Lausanne-Geneva, Rue du Bugnon 21, 1011 Lausanne, Switzerland. cristian.palmiere@chuv.ch
authors.forename: Cristian
authors.initials: C
authors.lastname: Palmiere
authors.forename: Frank
authors.initials: F
authors.lastname: Sporkert
authors.forename: Dominique
authors.initials: D
authors.lastname: Werner
authors.forename: Daniel
authors.initials: D
authors.lastname: Bardy
authors.forename: Marc
authors.initials: M
authors.lastname: Augsburger
authors.forename: Patrice
authors.initials: P
authors.lastname: Mangin
mesh_terms: D019840:2-Propanol / Q000032:analysis*; D020155:3-Hydroxybutyric Acid / Q000032:analysis; D000090:Acetoacetates / Q000032:analysis; D000096:Acetone / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D005410:Flame Ionization; D049429:Forensic Pathology; D005947:Glucose / Q000032:analysis; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007035:Hypothermia / Q000378:metabolism; D007662:Ketosis / Q000378:metabolism*; D011180:Postmortem Changes; D014168:Transferrin / Q000031:analogs & derivatives / Q000032:analysis; D014822:Vitreous Body / Q000737:chemistry*
chemical_list: D019840:2-Propanol; D020155:3-Hydroxybutyric Acid; D000090:Acetoacetates; D000096:Acetone; D015415:Biomarkers; D005947:Glucose; D006442:Glycated Hemoglobin; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C016635:acetoacetic acid