Beta Hydroxybutyrate, Plasma

Diagnostic Use

Beta hydroxybutyrate (bOH-B) is one of the two major ketone bodies produced by the liver as a byproduct of fatty acid metabolism.

Measurement of plasma ketones can be helpful when investigating a high anion gap metabolic acidosis. Causes of ketosis include relative insulin deficiency (e.g. diabetes), alcohol excess and starvation.

Department

Core Biochemistry

Delphic Registration Code

BETA

Synonyms

B-OH Butyrate
BOHB

Turnaround Time

3 hours

Test Code

5421

Specimen Type

• Serum
• Plasma

Specimen Requirements

Tube/Container Type:

Preferred

• Lithium Heparin - Non-gel (Green Cap)

Preferred if West Coast

• Lithium Heparin - Gel (Light Green Cap)

Acceptable

• Serum (Red Cap)
• SST II (Gold Cap)
• Lithium Heparin - Gel (Light Green Cap)

Preferred Sample Volume (ml)

4.5

No of Samples Required

1

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

• Lithium Heparin - Non-gel (Green Cap)

Acceptable

• Lithium Heparin - Gel (Light Green Cap)

Preferred Sample Volume (ml)

0.6

Additional Specimen Information

Significant positive interference from haemolysis.

Paediatric Specimen - Heparin microtainer 600 µL

Aliquot Instructions

Sample Type

• Serum
• Plasma

Minimum Volume (ml)

0.1

Transport to Lab

Chilled (2 - 8 degrees Celsius)
If overnight - Frozen

Additional Referral/Aliquot Information

Aliquot transport: Serum, plasma stable for 48 hours at 2-8°C.

>48 hours transport frozen (on ice).

Interpretation

An elevated plasma bOH-B is indicative of ketosis. The result should be interpreted in the clinical context and in consideration with the results of other tests such as venous/arterial blood gas and glucose.

The most common cause for a significant ketosis is diabetic ketoacidosis. Diabetic patients taking sodium-glucose cotransporter 2 (SGLT-2) inhibitors may develop a ketoacidosis in the absence of hyperglycaemia (euglycaemic ketoacidosis).

Other causes for ketosis (+/- acidosis) include starvation and alcohol excess.

Patients on a ketogenic diet may develop a mild elevation of plasma bOH-B however it is unlikely that these patients will develop an acidosis.

Reference Intervals

<0.3 mmol/L

Test Method

Kinetic enzymatic method performed on Beckman Coulter AU5822 analyser using Randox reagents.

Non-Funded Test Cost

$13.78 (Exclusive of GST)

Billing Code

5421

Contact Information

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