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
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.
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 |
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
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.
Test Components
beta-hydroxybutyrate
Methodology
Enzymatic Spectrophotometric (Roche Diagnostics)
CPT Codes
82010
LOINC Codes
6873-4
Synonyms/Keyword Search
ACETONE, ACETOACETIC ACID, B-HYDROXYBUTYRATE, KETB, BHOB
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.
Last Review Date
6/2/25