Associations between ketone bodies and fasting plasma glucose in individuals with post-pancreatitis prediabetes.

Levels of ketone bodies are altered in both acute pancreatitis and type 1 and type 2 diabetes. However, the role of ketone bodies in the pathogenesis of abnormal glucose metabolism after pancreatitis is largely unknown. To investigate the associations between ketone bodies and glucose homeostasis in individuals with post-pancreatitis prediabetes (PPP) versus normoglycaemia after pancreatitis (NAP). Fasting blood samples were analysed for acetoacetate, -hydroxybutyrate, and markers of glucose metabolism at a median of 26 months after acute pancreatitis. A series of linear regression analyses were conducted adjusting for patient- and pancreatitis-related characteristics. The study included 27 individuals with PPP and 52 with NAP. -hydroxybutyrate was significantly associated with fasting plasma glucose ( .002) and explained 26.2% of its variance in PPP, but not in NAP ( = .814; 0%). Acetoacetate was not significantly associated with fasting plasma glucose in both PPP ( = .681) or NAP ( = .661). An inverse association between -hydroxybutyrate and fasting plasma glucose characterises PPP and this may have translational implications.