RT Journal Article
SR Electronic
T1 Capillary Blood Beta-Hydroxybutyrate Measurement by Reagent Strip in Diagnosing Diabetic Ketoacidosis
JF American Society for Clinical Laboratory Science
JO Clin Lab Sci
FD American Society of Chemistry and Laboratory Science
SP 139
OP 144
DO 10.29074/ascls.18.3.139
VO 18
IS 3
A1 Puntip Tantiwong
A1 Gobchai Puavilai
A1 Boonsong Ongphiphadhanakul
A1 Pongamorn Bunnag
A1 Chardpraorn Ngarmukos
YR 2005
UL http://hwmaint.clsjournal.ascls.org/content/18/3/139.abstract
AB OBJECTIVE: To compare blood beta-hydroxybutyrate (β-OHB) levels measured by reagent strip with serum ketone levels assessed by the nitroprusside reaction in diagnosing diabetic ketoacidosis (DKA).DESIGN: Prospective study of DKA in 19 Thai diabetic patients from September 2001 until August 2002.SETTING: A university hospital.PATIENTS: Nineteen patients with DKA and ten patients with metabolic acidosis from other causes.INTERVENTIONS: Capillary blood β-OHB was measured by a blood ketone meter (MediSense® Optium™). Concurrently, serum ketone was measured semiquantitatively by nitroprusside reaction (Ketostix®, N-multistix®, and Labstix®).MAIN OUTCOME MEASURE: Sensitivity, specificity, and ROC curve of both methods in diagnosing DKA.RESULT: Mean age ± SD of DKA patients was 45.6 ± 16.95 years. Plasma glucose was 675.25 ± 188.15 mg/dL, arterial blood pH 7.19 ± 0.12, anion gap and serum bicarbonate 29.93 ± 4.90 and 8 ± 3.35 mmol/L. Serum ketone was moderately to markedly positive in most cases. Capillary β-OHB ranged from 2.4 to >6 mmol/L. The sensitivity and specificity of serum ketone by nitroprusside reaction in diagnosing DKA were 95% and 100%. The sensitivity and specificity of capillary β-OHB was 90% and 100% respectively. The areas under ROC curves of serum ketone and capillary β-OHB were 0.975 and 0.950 (NS) respectively.CONCLUSION: Serum ketone and blood β-OHB measurement are equally effective in diagnosing DKA among uncomplicated cases.ABBREVIATIONS: β-OHB = beta-hydroxybutyrate; DKA = diabetic ketoacidosis; MA = metabolic acidosis; ROC = receiver operating characteristic.