title: [Establishment of blood β-hydroxybutyrate threshold for diagnosis of type 2 diabetes ketoacidosis].
abstract: OBJECTIVE
  To establish of blood beta hydroxybutyrate (βOHB) threshold for diagnosing type 2 diabetes ketoacidosis (DKA) and explore the relationship between βOHB levels and the severity of DKA.
  
  
  METHODS
  Correlation analysis was performed between serum βOHB and [HCO(3)] in type 2 diabetic patients admitted in the emergency department in the past year. Regression equation was used to calculate the concentration of βOHB corresponding to a [HCO(3)] level of 18.0, 15, and 10.0 mmol/L, and βOHB concentration corresponding to a [HCO(3)] level of 18.0 mmol/l was used as the DKA diagnostic threshold.
  
  
  RESULTS
  The serum βOHB level and [HCO3] concentration showed a good correlation (R²=0.7023, P<0.001). βOHB concentrations that corresponded to a [HCO(3)] level of 18.0, 15, and 10.0 mmol/L were 3.0, 4.70, and 7.5 mmol/L, respectively, in accordance with the severity of DKA. Combined with the blood glucose concentration ≥ 13.9 mmol/L, a blood βOHB≥3.0 mmol/L showed a sensitivity of 99%, specificity of 86%, and total effectiveness of 92.81% for diagnosing DKA.
  
  
  CONCLUSIONS
  A serum βOHB level above 3.0 mmol/L can be used as the diagnostic threshold of DKA. βOHB can serve as an index for assessing the severity of DKA.
authors.affiliation: Clinical Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China.E-mail: kevinland020@163.com.
authors.forename: Peifeng
authors.initials: P
authors.lastname: Ke
authors.forename: Haitao
authors.initials: H
authors.lastname: Zhou
authors.forename: Zemin
authors.initials: Z
authors.lastname: Wang
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wu
authors.forename: Haibiao
authors.initials: H
authors.lastname: Lin
authors.forename: Xianzhang
authors.initials: X
authors.lastname: Huang
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D016883:Diabetic Ketoacidosis / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D020155:3-Hydroxybutyric Acid