Ketonemia

Ketonemia is a medical condition characterized by an elevated level of ketone bodies in the blood. Ketone bodies include acetoacetate, β-hydroxybutyrate, and acetone, which are produced during the breakdown of fats for energy when glucose is not readily available.

Causes:

1. Diabetes Mellitus (especially Type 1): Inadequate insulin levels prevent glucose from entering cells for energy. As a result, the body begins to break down fats, leading to the production of ketone bodies.

2. Starvation or Prolonged Fasting: When the body depletes its carbohydrate stores, it turns to fat as an alternative energy source, resulting in increased ketone production.

3. Low-Carbohydrate Diets (e.g., ketogenic diet): Low intake of carbohydrates forces the body to use fat for energy, leading to ketosis.

4. Intense Exercise: Prolonged intense physical activity can deplete glycogen stores, prompting the body to break down fats and produce ketones.

5. Alcoholism: Excessive alcohol consumption can alter metabolism and contribute to the production of ketone bodies.

Symptoms:

• Early symptoms might include excessive thirst, frequent urination, and dry mouth due to dehydration.
• Fruity or acetone-like breath odor.
• Fatigue and weakness because ketone bodies replace glucose as the primary energy source.
• Nausea and vomiting, as the body attempts to cope with high levels of ketones.
• Severe cases can lead to ketoacidosis, a dangerous condition that includes symptoms such as abdominal pain, confusion, difficulty breathing, and even coma.

Diagnosis:

• Blood Tests: Measures levels of ketone bodies like β-hydroxybutyrate and acetoacetate in the blood. The ratio of β-hydroxybutyrate to acetoacetate in the blood typically ranges from 1:1 to 10:1.
• Urine Tests: Despite not being a diagnostic marker for blood ketone levels, urine tests can indicate the presence of ketone bodies as seen in ketonuria.

Management and Treatment:

• For Diabetics: Immediate insulin therapy to reduce blood glucose and ketone levels. Hydration and electrolyte replacement are also crucial.
• For Starvation or Prolonged Fasting: Reintroducing carbohydrates to restore normal glucose levels.
• For Low-Carbohydrate Diets: Monitoring ketone levels to ensure they remain within a safe range.
• For Alcoholism: Addressing alcohol use and metabolic imbalances through medical detoxification and supportive care.

Conclusion:

Ketonemia reflects a metabolic shift where ketone bodies are used as an alternative energy source due to inadequate glucose availability. Detecting elevated ketone levels in the blood is crucial, especially in individuals with diabetes, as it can lead to ketoacidosis, a potentially life-threatening condition. Prompt diagnosis and treatment are essential to prevent complications and restore normal metabolic functions.

Source | Glossary of Most Commonly Used Biomedical Terms and Concepts | Lithuanian University of Health Sciences | Academician Professor Antanas Praškevičius, Professor Laima Ivanovienė