TY - JOUR
T1 - The relationship of a high level of serum beta-hydroxybutyrate to cause of death
AU - Kanetake, Jun
AU - Kanawaku, Yoshimasa
AU - Mimasaka, Sohtaro
AU - Sakai, Jun
AU - Hashiyada, Masaki
AU - Nata, Masayuki
AU - Funayama, Masato
PY - 2005/5
Y1 - 2005/5
N2 - To examine the state of ketoacidosis in relation to the cause of death, three kinds of ketone bodies (acetoacetate, beta-hydroxybutyrate and acetone) were measured in postmortem serum. Of 100 autopsy cases, 22 had ketone body increasing pathophysiological conditions, overlapped in some cases, namely a poorly-nourished state (10 cases), alcoholic fatty liver damage (10), diabetes (5) and infectious disease (5). Of the 3, 11, 7 and 15 cases in which the beta-hydroxybutyrate concentration was greater than 10,000, 1000-10,000, 500-1000 and 200-500 μmol/l, 3 (100%), 8 (73%), 3 (43%) and 5 (33%), respectively, had one or more pathophysiological conditions that usually produce ketone bodies. Of the 64 cases in which the beta-hydroxybutyrate concentrations were less than 200 μmol/l, only 3 (5%) had some of these conditions. Cases showing high levels of ketone bodies tended to have pathophysiological states that can produce them, although the level of beta-hydroxybutyrate and these states did not show parallel relationships. When autopsy findings fail to explain the cause of death, a diagnosis as death caused by ketoacidosis would be reasonable if the serum beta-hydroxybutyrate level is over 1000 μmol/l and the body has pathophysiological conditions that tend to increase ketone bodies.
AB - To examine the state of ketoacidosis in relation to the cause of death, three kinds of ketone bodies (acetoacetate, beta-hydroxybutyrate and acetone) were measured in postmortem serum. Of 100 autopsy cases, 22 had ketone body increasing pathophysiological conditions, overlapped in some cases, namely a poorly-nourished state (10 cases), alcoholic fatty liver damage (10), diabetes (5) and infectious disease (5). Of the 3, 11, 7 and 15 cases in which the beta-hydroxybutyrate concentration was greater than 10,000, 1000-10,000, 500-1000 and 200-500 μmol/l, 3 (100%), 8 (73%), 3 (43%) and 5 (33%), respectively, had one or more pathophysiological conditions that usually produce ketone bodies. Of the 64 cases in which the beta-hydroxybutyrate concentrations were less than 200 μmol/l, only 3 (5%) had some of these conditions. Cases showing high levels of ketone bodies tended to have pathophysiological states that can produce them, although the level of beta-hydroxybutyrate and these states did not show parallel relationships. When autopsy findings fail to explain the cause of death, a diagnosis as death caused by ketoacidosis would be reasonable if the serum beta-hydroxybutyrate level is over 1000 μmol/l and the body has pathophysiological conditions that tend to increase ketone bodies.
KW - Beta-hydroxybutyrate
KW - Body serum
KW - Cause of death
KW - Ketoacidosis
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U2 - 10.1016/j.legalmed.2005.01.003
DO - 10.1016/j.legalmed.2005.01.003
M3 - Article
C2 - 15847825
AN - SCOPUS:17444368998
VL - 7
SP - 169
EP - 174
JO - Legal Medicine
JF - Legal Medicine
SN - 1344-6223
IS - 3
ER -