beta-Hydroxybutyric acid Unit Conversion

β-Hydroxybutyric acid, also known as 3-hydroxybutyric acid, is an organic compound and a beta hydroxy acid with the formula CH3CH(OH)CH2CO2H; its conjugate base is beta-hydroxybutyrate, also known as 3-hydroxybutyrate.

In diabetic ketoacidosis (DKA), three ketone bodies are produced: β-hydroxybutyrate (BHB), acetoacetic acid, and acetone. β-hydroxybutyrate is present in the greatest concentration and accounts for approximately 75% of the three ketone bodies. During periods of ketosis, β-hydroxybutyrate increases even more than acetoacetate and acetone and has been shown to be a better indicator of ketoacidosis, including subclinical ketosis. Other names for this test include 3-hydroxybutyric acid and ketones. Testing for ketones is generally performed with nitroprusside (Acetest) tablets or reagent sticks. A 4+ reaction with serum diluted 1:1 is strongly suggestive of ketoacidosis. Nitroprusside reacts with acetoacetate and acetone but not with BHB. This is important because β-hydroxybutyrate is the predominant ketone, particularly in severe DKA. It is, therefore, possible to have a negative serum nitroprusside reaction in the presence of severe ketosis.

• Monitoring therapy for DKA.
• Investigating the differential diagnosis of any patient presenting to the emergency department with hypoglycemia, acidosis, suspected alcohol ingestion, or an unexplained increase in the AG.
• In pediatric patients, the presence or absence of ketonemia/urea is an essential component in the differential diagnosis of inborn errors of metabolism.
• Key parameter monitored during controlled 24-hour fasts.

Increased In

• Alcoholic ketoacidosis
• Lactic acidosis (shock, renal failure)
• Liver disease
• Infections
• Phenformin and salicylate poisoning