Weingart Christiane, Lotz Fabian, Kohn Barbara
Clinic of Small Animals, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
J Vet Diagn Invest. 2012 Mar;24(2):295-300. doi: 10.1177/1040638711428332. Epub 2011 Dec 6.
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM). The standard method of detection of ketone bodies is the dipstick method, which detects semiquantitatively acetoacetate, but not β-hydroxybutyrate (β-HB). The objectives of the current study were to assess the diagnostic utility of β-HB to diagnose diabetic ketosis (DK) and DKA in cats and to establish a cut-off value for the diagnosis of DKA. Sixty-two cats were included in the study. Eleven cats were healthy (group 1); in the remainder of cats (51), a diagnosis of DM was based on hyperglycemia, glucosuria, and increased fructosamine concentrations. Nineteen of 51 cats suffered from nonketotic diabetes mellitus (group 2). In 11 cats, plasma ketone bodies were detected with the dipstick method (diabetic ketosis, group 3). In 21 cats, plasma ketone bodies and metabolic acidosis were present (DKA, group 4). Plasma β-HB was measured in all cats by an enzymatic method (spectrophotometry). A cut-off value for the diagnosis of DKA was calculated based on the receiver operating characteristic curve. In healthy cats, the β-HB concentration ranged from 0 to 0.1 mmol/l; in cats of group 2, from 0 to 0.9 mmol/l (median: 0.1 mmol/l); in cats of group 3, from 0.6 to 6.8 mmol/l (median: 1.7 mmol/l); and in cats of group 4, from 3.8 to 12.2 mmol/l (median: 7.9 mmol/l). A cut-off value of 2.4 mmol/l revealed 100% sensitivity and 87% specificity to diagnose DKA. Beta-hydroxybutyrate is a useful parameter for the diagnosis of diabetic ketosis and DKA in cats.
糖尿病酮症酸中毒（DKA）是糖尿病（DM）的一种危及生命的并发症。检测酮体的标准方法是试纸法，该方法可半定量检测乙酰乙酸，但不能检测β-羟基丁酸（β-HB）。本研究的目的是评估β-HB在诊断猫糖尿病酮症（DK）和DKA中的诊断效用，并确定DKA诊断的临界值。62只猫纳入本研究。11只猫健康（第1组）；其余51只猫中，根据高血糖、糖尿和果糖胺浓度升高诊断为DM。51只猫中有19只患有非酮症糖尿病（第2组）。11只猫用试纸法检测到血浆酮体（糖尿病酮症，第3组）。21只猫存在血浆酮体和代谢性酸中毒（DKA，第4组）。所有猫均采用酶法（分光光度法）测定血浆β-HB。根据受试者工作特征曲线计算DKA诊断的临界值。健康猫的β-HB浓度范围为0至0.1 mmol/L；第2组猫为0至0.9 mmol/L（中位数：0.1 mmol/L）；第3组猫为0.6至6.8 mmol/L（中位数：1.7 mmol/L）；第4组猫为3.8至12.2 mmol/L（中位数：7.9 mmol/L）。2.4 mmol/L的临界值诊断DKA的敏感性为100%，特异性为87%。β-羟基丁酸是诊断猫糖尿病酮症和DKA的有用参数。
