Biochemistry

Preferred Sample Type

3 Hydroxy Butyrate

3 Hydroxy Butyrate

Specimen Volume

1mL blood. Min.vol.100 uL plasma

Specimen Transport

Send sample on the first available transport

Sample Preparation

Centrifuge and send to reference laboratory ASAP.

Turnaround Time

2 weeks

Sample Processing In Laboratory

No special transport conditions.  Sample should be transported to laboratory asap

Sample Stability

Freeze plasma at -20 oC if not sent immediately.

General Information

The measurement of 3-hydoxy-butyrate is used together with free fatty acids (FFA) as a useful first line indicator of inherited defects of mitochondrial fatty acid catabolism. Ideally specimens should be taken during acute hypoglycaemic episodes or after a provocative fast. In most circumstances, as blood glucose falls, lipolysis and subsequently ketogenesis are stimulated; thus the plasma concentration of FFA and 3-hydroxybutyrate increase in an approximately equimolar fashion. In fatty acid oxidation defects, lipolysis will still be stimulated in response to a drop in blood glucose, but ketogenesis will be reduced. Therefore, a disproportionately high free fatty acid concentration relative to a low 3-hydroxy-butyrate concentration is found, particularly during periods of stress i.e. infection, coma, fasting and hypoglycaemia. In patients with hyperinsulinism, FFA and 3- hydroxybutyrate levels will both be low, as insulin suppresses lipolysis. This pattern will also be observed in patients with hypopituitarism, therefore this test can not be used to diagnose hyperinsulinism. However, hyperinsulinism can be ruled out by the demonstration of ketosis, i.e. elevated FFA and 3-hydroxy butyrate in the presence of hypoglycaemia. See www.metbio.net for Best Practice Guidelines for the Investigation of Hypoglycaemia in Infants and Children.

Patient Preparation

Please supply glucose result and details of fasting.

Notes

None Given

Reference Range

Provided by reference laboratory.

Specifications

  • EQA Status: Referral Laboratory participates in an EQA scheme
  • EQAS Scheme: Yes

Related Tests

Glucose (Plasma)

Creation Date

Monday, 08 August 2011

Modification Date

Sunday, 18 February 2018

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Protection of Personal Information – Clinical Laboratory Services comply with the Trust Data Protection Policy and have procedures in place to allow the Directorate and it’s employees to comply with the Data Protection Act 1998 and associated best practice and guidance.

University Hospitals Birmingham medical laboratories at Queen Elizabeth Hospital, Heartlands Hospital, Good Hope Hospital and Solihull Hospital are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/

  • Molecular Pathology is a UKAS accredited medical laboratory No. 8759
  • Biochemistry is a UKAS accredited medical laboratory No. 8910
  • Haematology and Transfusion is a UKAS accredited medical laboratory No. 8784
  • Clinical Microbiology is a UKAS accredited medical laboratory No. 8760
  • Cellular Pathology is a UKAS accredited medical laboratory No. 10141
  • Musculoskeletal laboratory is a UKAS accredited medical laboratory No. 9897
  • Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217.

Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further test information, please visit the test database: http://qehbpathology.uk/test-database

For further information contact Louise Fallon, Quality Manager, 0121 371 5962