β-Hydroxybutyrate

CPT: 82010
Updated on 6/15/2019
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Synonyms

  • 3-Hydroxybutyrate (3HB)
  • Beta-Hydroxybutyric Acid
  • Ketone Bodies

Expected Turnaround Time

3 - 10 days

3 - 10 days


Related Documents


Specimen Requirements


Specimen

Serum (preferred) or plasma, frozen


Volume

1 mL


Minimum Volume

0.5 mL (Note: This volume does not allow for repeat testing.)


Container

Red-top tube, gel-barrier tube, lavender-top (EDTA) tube, or green-top (sodium heparin) tube.


Collection

Serum/plasma must be separated from cells within two hours of venipuncture. Transfer separated serum/plasma to a plastic transport tube. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.


Storage Instructions

Freeze.


Stability Requirements

Temperature

Period

Room temperature

8 hours

Refrigerated

2 days

Frozen

11 days

Freeze/thaw cycles

Stable x3


Patient Preparation

Patient should be fasting.


Causes for Rejection

Gross hemolysis


Test Details


Use

β-hydroxybutyrate is one of three sources of ketone bodies. Ketoacidosis in diabetes usually occurs with decreased plasma pH and bicarbonate, increased glucose, and other abnormalities. As ketoacidosis and metabolic acidosis are treated, hypokalemia may become evident. A normal or low potassium on admission with ketoacidosis may indicate severe potassium depletion.1 Thus, potassium is among parameters to follow in treatment of ketoacidosis. In children younger than 10 years of age, diabetic ketoacidosis is reported to account for 70% of diabetes-related deaths.2


Limitations

The β-hydroxybutyrate assay will not detect acetoacetic acid and acetone. Acidosis shifts equilibrium toward β-hydroxybutyrate, but treatment of ketoacidosis results in increased acetoacetate and a more positive "acetone" reaction before ketone bodies decrease.3


Methodology

Spectrophotometric


Reference Interval

All ages (fasting): 0.2−2.8 mg/dL


Footnotes

1. Bienia R, Ripoll I. Diabetic ketoacidosis. JAMA. 1979 Feb 2; 241(5):510-511. 104058
2. Bonadio WA, Gutzeit MF, Losek JD, Smith DS. Outpatient management of diabetic ketoacidosis. Am J Dis Child. 1988 Apr; 142(4):448-450. 3126645
3. Schade DS, Eaton RP. Differential diagnosis and therapy of hypoketonemic state. JAMA. 1979 May 11; 241(19):2064-2065. 107340

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