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Test Code KETB KETONES

Specimen and Container/Tube

Specimen Type: Plasma

Preferred Specimen: Li-Heparin Mint Green Top

Other Acceptable specimens: Serum/Gold Top, Serum/Red Top

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: 

Collect specimen per standard collection procedure and send to laboratory immediately. 

 

UCMC Offsite and UC MedLab Outreach Instructions: 

  • Samples should be centrifuged within 2 hours of collection.
  • Centrifuge specimens at >2500 x g for 10 minutes at room temperature.
  • Aliquot sample into plastic transport tube containing a minimum of 0.2 mL of specimen.
  • Samples must be sent room temperature at 15-25oC.

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits. 
  • Specimens that are clotted or grossly hemolyzed.
  • Specimens that were transported unspun/whole blood and draw time is greater than 6 hours.

Reference Values

 

Test

Age

Sex

Reference Range

KETB

All

All

<0.30 mmol/L

Note: Reference range based on in-house studies, recommendations from Tietz Textbook of Clinical Chemistry, and Roche product literature.  

Critical Values

Analyte

Unit

Low

High

Age

N/A

N/A

N/A

N/A

N/A

CPT Codes

82010

LOINC Codes

6873-4

Volume

Preferred Volume: 0.5 mL

Minimum Volume: 0.2 mL

Specimen Stability

Storage Temperature

Stability

Refrigerated

7 days

Collection Instructions

Collect specimen per standard laboratory collection procedures. 

 

Test Components

beta-hydroxybutyrate

Clinical Indications

Beta-hydroxybutyrate (BHB) is 1 of 3 sources of ketone bodies. Its relative proportion in the blood (78%) is greater than the other 2 ketone bodies, acetoacetate (20%) and acetone (2%). During carbohydrate deprivation (starvation, digestive disturbances, frequent vomiting), decreased carbohydrate utilization (diabetes mellitus), glycogen storage diseases, and alkalosis, acetoacetate production increases. The increase may exceed the metabolic capacity of the peripheral tissues. As acetoacetate accumulates in the blood, a small amount is converted to acetone by spontaneous decarboxylation. The remaining and greater portion of acetoacetate is converted to BHB.

Methodology

Enzymatic Spectrophotometric  (Roche Diagnostics)

Additional Information

  • The beta-hydroxybutyrate (BHB)/acetoacetate ratio is typically between 3:1 and 7:1 in severe ketotic states.

     

    Serum BHB increases in response to fasting, but should not exceed 0.4 mmol/L following an overnight fast (up to 12 hours).

     

    In pediatric patients, a hypo- or hyper-ketotic state (with or without hypoglycemia) may suggest specific groups of metabolic disorders.

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

 

STAT Turnaround Time: 1 hour

Routine Turnaround Time: 4 hours

Testing Schedule: 24/7

Synonyms/Keyword Search

ACETONE, ACETOACETIC ACID, B-HYDROXYBUTYRATE, KETB

Last Review Date

07/02/2024