[Metabolic ketoacidosis in obese subjects resulting from dietetic and exercise regimens to reduce excess body weight].

62 obese patients (44 women, and 18 men), mean age 43 years, were treated for one month in the rehabilitation center in Loznitsa by a hypocaloric diet and e physically active regimen. The average reduction of body mass was 11,248 +/- 3,392 kg. The treatment led to a marked ketosis--increase of pyruvate, acetacetate and beta-hydroxybutyrate, the increase of the most active metabolic component--beta-hydroxybutyrate being the greatest. The increased ratio beta-hydroxybutyrate/acetacetate could be considered favourable in relation to the energetic dysbalance since beta-hydroxybutyrate metabolizes faster than acetacetate. In patients with disturbed glucose tolerance, as well-as in patients with liver and renal diseases, gallstone disease, podagra and disturbed calcium-phosphorus metabolism the body mass reducing regimen should be carried out strictly individually and carefully in order to avoid the unfavourable effect of severe metabolic disturbances which could arise because of pronounced ketoacidosis.