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The accumulation of acetyl-CoA in turn produces excess ketone bodies through ketogenesis. [11] The result is a rate of ketone production higher than the rate of ketone disposal, and a decrease in blood pH. [12] In extreme cases the resulting acetone can be detected in the patient's breath as a faint, sweet odor.
Ketoacidosis is a metabolic state caused by uncontrolled production of ketone bodies that cause a metabolic acidosis.While ketosis refers to any elevation of blood ketones, ketoacidosis is a specific pathologic condition that results in changes in blood pH and requires medical attention.
Acetone is also produced and is expired by the lungs. [1] Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading. As with tests for glucose, acetoacetate can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetoacetate.
Test for ketonuria using Bayer Ketostix reagent strips. Urine testing is the most common method of testing for ketones. Urine test strips utilize a nitroprusside reaction with acetoacetate to give a semi-quantitative measure based on color change of the strip. Although beta-hydroxybutyrate is the predominant circulating ketone, urine test ...
Ketone bodies are water-soluble molecules or compounds that contain the ketone groups produced from fatty acids by the liver (ketogenesis). [1] [2] Ketone bodies are readily transported into tissues outside the liver, where they are converted into acetyl-CoA (acetyl-Coenzyme A) – which then enters the citric acid cycle (Krebs cycle) and is oxidized for energy.
Ketones occur in three forms in the body: beta-hydroxybutyrate (BHB), acetone and acetoacetate. Test strips use sodium nitroprusside to detect acetoacetate, and those with a glycine additive can detect acetone; however, none detect BHB. The reaction of ketones with sodium nitroprusside in an alkaline medium turns the test pad purple. [76]
DKA results from a shortage of insulin; in response, the body switches to burning fatty acids, which produces acidic ketone bodies. [3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH and keto acids in either the blood or urine. [1] The primary treatment of DKA is with intravenous fluids and insulin. [1]
The term ketones or ketone bodies in reality refers to three intermediate products in the metabolism of fatty acids; acetone, acetoacetic acid and beta-hydroxybutyric acid. Elevated concentrations of ketones are not generally found in urine, as all these substances are completely metabolized, producing energy, carbon dioxide and water.