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Development of Paper-strip Test for 3-Hydroxybutyrate and its Clinical Application

  1. Yutaka Harano, M.D.,
  2. Masaaki Suzuki, M.D.,
  3. Hideto Kojima, M.D.,
  4. Atsunori Kashiwagi, M.D. Ph.D.,
  5. Hideki Hidaka, M.D. Ph.D. and
  6. Yukio Shigeta, M.D. Ph.D.
  1. Third Department of Medicine, Shiga University of Medical Science Seta Ohtsu, Shiga 520-21, Japan
  1. Address reprint requests to Yutaka Harano, M.D., Ph.D., ThirdDepartment of Medicine, Shiga University of Medical Science, Tsukinowa-cho, Seta, Ohtsu, Shiga 520-21, Japan.

Abstract

A rapid paper-strip test for the semiquantitating 3-hydroxybutyrate (3-OHBA) has been developed. The color develops within 5 min after applying the serum to the paper strip, and the purple color was read either visually or by reflectance meter. This can detect 3-OHBA levels as low as 0.1 mmol/L up to 2.0 mmol/L. The more concentrated sample can be measured on serial dilution. Clinical usefulness has been tested in a summer camp for insulin-dependent diabetic children as well as in a routine diabetes clinic. Serum 3-OHBA levels ranged from > 100 µumol/L to 4 mmol/L in all the subjects before breakfast in a summer camp. In four subjects, 3-OHBA was elevated to the level of 2–4 mmol/L, and only one of these four subjects exhibited ketonuria by nitroprusside test. In a diabetes clinic, a new paper-strip test for 3-OHBA has revealed ketonemia in 34 (74%) of 46 diabetic subjects, while nitro-prusside test revealed ketonemia in only 4 (13%). The present paper-strip test for 3-OHBA is sensitive enough to detect levels as low as 0.1 mmol/L and is clinically useful for rapid detection of ketosis proneness as well as for monitoring of diabetes control.

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