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HelpTest Code BHYD Beta-Hydroxybutyrate, Serum
Reporting Name
Beta-Hydroxybutyrate, SUseful For
Monitoring therapy for diabetic ketoacidosis
Investigating the differential diagnosis of any patient presenting to the emergency room with hypoglycemia, acidosis, suspected alcohol ingestion, or an unexplained increase in the anion gap
In pediatric patients, the presence or absence of ketonemia/uria is an essential component in the differential diagnosis of inborn errors of metabolism
Serum beta-hydroxybutyrate is a key parameter monitored during controlled 24-hour fasts
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen (preferred) | 7 days | |
| Refrigerated | 7 days |
Reference Values
<0.4 mmol/L
Day(s) Performed
Monday through Sunday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
82010
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| BHYD | Beta-Hydroxybutyrate, S | 6873-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| BHYD | Beta-Hydroxybutyrate, S | 6873-4 |
Interpretation
The beta-hydroxybutyrate (BHB)/acetoacetate ratio is typically between 3:1 and 7:1 in severe ketotic states.
Serum BHB increases in response to fasting, but should not exceed 0.4 mmol/L following an overnight fast (up to 12 hours).
In pediatric patients, a hypo- or hyper-ketotic state (with or without hypoglycemia) may suggest specific groups of metabolic disorders.
Clinical Reference
1. Tietz Textbook of Clinical Chemistry. Edited by CA Burtis, ER Ashwood. Philadelphia, WB Saunders Co. 1999
2. Vassault A, Bonnefont JP, Specola N, et al: Lactate, pyruvate, and ketone bodies. In Techniques in Diagnostic Human Biochemical Genetics - A Laboratory Manual. Edited by F Hommes. New York, Wiley-Liss, 1991
3. Bonnefont JP, Specola NB, Vassault A, et al: The fasting test in paediatrics: application to the diagnosis of pathological hypo- and hyperketotic states. Eur J Pediatr 1990;150:80-85
Report Available
Same day/1 to 2 daysMethod Name
Photometric, B-Hydroxybutyrate Dehydrogenase (B-HBDH)