[血清β-羟基丁酸在糖尿病酮症或糖尿病酮症酸中毒中的诊断价值]

[The diagnostic value of serum beta-hydroxybutyrate in diabetic ketosis or diabetic ketoacidosis].

作者信息

Yang Hui-Lan, Yuan Gao-Pin, Deng Hao, Chen Cheng, Peng Xi, An Zhen-Mei

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2014 Mar;45(2):270-3.

PMID:24749355

Abstract

OBJECTIVE

To determine the diagnostic value of serum beta-hydroxybutyrate (betaOHB) in diabetic ketosis or diabetic ketoacidosis.

METHODS

We conducted a retrospective review of clinical data, in West China Hospital from May 2011 to May 2013, of 1 209 patients with non-ketosis diabetics (DM group), 262 patients with diabetic ketosis or diabetic ketoacidosis (DK/DKA group), and 480 healthy people undergoing routine medical examinations (normal control group). Logistic regression analyses and ROC curves were performed in determining the diagnostic value of betaOHB for DK/DKA.

RESULTS

The level of serum betaOHB was much higher in the DK/DKA patients than that of the participants in the DM group and normal control group (P < 0.01). The serum betaOHB turned negative earlier than urine ketone (P < 0.01) in the DK/DKA patients. The logistic regression analysis indicated that betaOHB was one of the independent risk factors for DK/DKA. The betaOHB had an area under of 0.975 in ROC curve, with 1 mmol/L [sensitivity (Sen.) 85.1%, specificity (Spe.) 95. 3%, positive predictive value (PV+) 80.36%, negative predictive value (PV-) 96.89%] as a diagnostic point for DK/DKA and 0.66 mmol/L (Sen. 95%, Spe. 89.2%, PV+ 66.41%, PV- 99.9%) as a screening point.

CONCLUSION

Diabetic patients with a level or higher than 1 mmol/L serum betaOHB can accurately predict DK/DKA. Patients with a level or lower than 0.66 mmol/L serum betaOHB are unlikely to have DK/DKA.

摘要

目的

确定血清β-羟基丁酸（βOHB）在糖尿病酮症或糖尿病酮症酸中毒中的诊断价值。

方法

我们对2011年5月至2013年5月在华西医院的临床数据进行了回顾性分析，其中包括1209例非酮症糖尿病患者（糖尿病组）、262例糖尿病酮症或糖尿病酮症酸中毒患者（DK/DKA组）以及480例接受常规体检的健康人（正常对照组）。采用逻辑回归分析和ROC曲线来确定βOHB对DK/DKA的诊断价值。

结果

DK/DKA患者的血清βOHB水平显著高于糖尿病组和正常对照组的参与者（P<0.01）。在DK/DKA患者中，血清βOHB比尿酮更早转阴（P<0.01）。逻辑回归分析表明，βOHB是DK/DKA的独立危险因素之一。βOHB在ROC曲线下的面积为0.975，以1 mmol/L[灵敏度（Sen.）85.1%，特异度（Spe.）95.3%，阳性预测值（PV+）80.36%，阴性预测值（PV-）96.89%]作为DK/DKA的诊断切点，以0.66 mmol/L（Sen. 95%，Spe. 89.2%，PV+ 66.41%，PV- 99.9%）作为筛查切点。