Ketone Bodies Are Mildly Elevated in Subjects with Type 2 Diabetes Mellitus and Are Inversely Associated with Insulin Resistance as Measured by the Lipoprotein Insulin Resistance Index
Ketone Bodies Are Mildly Elevated in Subjects with Type 2 Diabetes Mellitus and Are Inversely Associated with Insulin Resistance as Measured by the Lipoprotein Insulin Resistance Index
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DOI：
10.3390/jcm9020321
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发表时间：
2020-02-01
影响因子：
3.9
通讯作者：
Connelly, Margery A.
中科院分区：
文献类型：
--
作者：
Garcia, Erwin;Shalaurova, Irina;Connelly, Margery A.
背景：量化轻度升高的酮体在临床和病理生理学上是相关的，特别是在疾病状态的背景下，以及对各种饮食和运动方案的监测。为了在临床实验室中检测酮体，开发了一种基于核磁共振波谱的检测方法，用于检测β-羟基丁酸酯(β-Hb)、乙酰乙酸乙酯(Acac)和丙酮。方法：对酮体含量测定的精密度、线性和稳定性进行评价，并进行方法比较。此外，在胰岛素抵抗动脉粥样硬化研究中(IRAS，n=1198；373例2型糖尿病(T2 DM)受试者)测定了血浆酮小体。结果：核磁共振和质谱法测定的β-Hb和acac与用核磁共振和气相色谱/质谱法测定的丙酮高度相关(r2分别为0.996、0.994和0.994)。对于β-Hb、acac和丙酮，批内和批间精密度的变异系数(%CV)分别为1.3%~9.3%、3.1%~7.7%和3.8%~9.1%。在IRA中，与非糖尿病患者相比，T2 DM患者的酮体升高(p=0.011
Background: Quantifying mildly elevated ketone bodies is clinically and pathophysiologically relevant, especially in the context of disease states as well as for monitoring of various diets and exercise regimens. As an alternative assay for measuring ketone bodies in the clinical laboratory, a nuclear magnetic resonance (NMR) spectroscopy-based test was developed for quantification of beta-hydroxybutyrate (beta-HB), acetoacetate (AcAc) and acetone. Methods: The ketone body assay was evaluated for precision, linearity and stability and method comparisons were performed. In addition, plasma ketone bodies were measured in the Insulin Resistance Atherosclerosis Study (IRAS, n = 1198; 373 type 2 diabetes mellitus (T2DM) subjects). Results: beta-HB and AcAc quantified using NMR and mass spectrometry and acetone quantified using NMR and gas chromatography/mass spectrometry were highly correlated (R-2 = 0.996, 0.994, and 0.994 for beta-HB, AcAc, acetone, respectively). Coefficients of variation (%CVs) for intra- and inter-assay precision ranged from 1.3% to 9.3%, 3.1% to 7.7%, and 3.8% to 9.1%, for beta-HB, AcAc and acetone, respectively. In the IRAS, ketone bodies were elevated in subjects with T2DM versus non-diabetic individuals (p = 0.011 to