The influence of ethanol on the level of ketone bodies in hypothermia

Teresiński, Grzegorz; Buszewicz, Grzegorz; Mądro, Roman

doi:10.1016/s0379-0738(02)00106-8

Cited by 46 publications

(33 citation statements)

References 21 publications

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“…The finding is consistent with observations made by various authors [1][2][3][4][5]. The disorders can have different underlying causes.…”

Section: Discussionsupporting

confidence: 93%

“…Powyższa praca wskazuje, że izolowane występo-wanie acetonu we krwi bądź jego współwystępowa-nie z niskimi stężeniami izopropanolu jest dobrym wskaźnikiem zaburzeń metabolicznych, co jest zgodne z obserwacjami poczynionymi przez róż-nych autorów [1][2][3][4][5]. Podłoże tych zaburzeń może być wielorakie.…”

Section: Dyskusjaunclassified

“…często nie występuje zwiększenie stężenia acetonu, za to charakterystyczny jest wzrost stężenia we krwi kwasu b-hydroksymasłowego (β-HBA), które również może być oznaczane we krwi pobranej ze zwłok, jednak wymaga to wykonania dodatkowego oznaczenia [5,7]. Trudności interpretacyjne stwarza sytuacja, w której współwystępuje aceton i izopropanol.…”

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Analysis of the origin and importance of acetone and isopropanol levels in the blood of the deceased for medico-legal testimony

Borowska-Solonynko¹,

Siwińska-Ziółkowska²,

Piotrkowicz³

et al. 2014

amsik

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Analiza pochodzenia i znaczenia dla celów opiniowania medyczno-sądowego stężeń acetonu i izopropanolu we krwi zmarłychAnalysis of the origin and importance of acetone and isopropanol levels in the blood of the deceased for medico-legal testimony StreszczenieCel pracy: Analiza częstości występowania acetonu i izopropanolu we krwi zmarłych oraz ocena przypadków, w któ-rych stwierdzono wymienione związki, pod kątem ich źródeł oraz przydatności opiniodawczej. Materiał i metody: Materiał do badań stanowiły wyniki badań na obecność alkoholu etylowego oraz protokoły sekcji zwłok wykonanych w Zakładzie Medycyny Sądowej Warszawskiego Uniwersytetu Medycznego od stycznia 2008 r. do kwietnia 2009 r. -łącznie 2475 przypadków. We właściwej grupie badanej (grupa B) znalazły się tylko te przypadki, w których stwierdzono obecność acetonu z izopropanolem lub bez niego we krwi [n = 202 (8,2%)]. Stężenia izopropanolu we krwi różniły się w zależności od przyczyny zgonu. Zwrócono uwagę na konieczność różnicowania źródeł pochodzenia izopropanolu w przypadku jego obecności we krwi zmarłego. Wyniki: Wyniki pracy wskazują, że różnicowanie to powinno być oparte na relacji stężeń izopropanolu i acetonu we krwi. Ocena samego stężenia nie jest wystarczająca. Nawet duże stężenia izopropanolu przy przewyższających je stę-żeniach acetonu wskazują na możliwość powstania izopropanolu w wyniku przemian acetonu. Stężenia izopropanolu przewyższające stężenia acetonu, zwłaszcza przy współwystępowaniu znacznej ilości etanolu, silnie przemawiają za egzogennym pochodzeniem izopropanolu.Słowa kluczowe: aceton, izopropanol, opiniowanie sądowo-lekarskie. AbstractThe aim of the study was to analyze the incidence of acetone and isopropanol in the blood of the deceased, and to assess cases in which the compounds have been detected with a focus on their origin and usefulness for medico-legal testimony. Material and methods:The study material consisted of results of tests detecting ethyl alcohol and reports of autopsies performed at the Department of Forensic Medicine, Medical University of Warsaw, from January 2008 to April 2009 -a total of 2,475 cases. The test group proper (group B) comprised only those cases in which acetone was detected in blood, either with or without isopropanol [n = 202 (8.2%)]. The blood levels of isopropanol varied depending on the cause of death. The need for differentiating the origin of isopropanol in the case of its presence in the blood of the deceased was pointed out. Results:The results of the present study show that the differentiation should be based on the isopropanol and acetone concentration ratio, as isopropanol concentration alone is not sufficient for preparing expert opinions. Even high concentrations of isopropanol, when accompanied by even higher concentrations of acetone, imply that isopropanol could have been formed as a result of acetone transformations. Isopropanol concentrations exceeding acetone levels strongly point to the exogenous origin of isopropanol, particularly when high levels of ethanol are concurre...

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“…The finding is consistent with observations made by various authors [1][2][3][4][5]. The disorders can have different underlying causes.…”

Section: Discussionsupporting

confidence: 93%

Section: Dyskusjaunclassified

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Analysis of the origin and importance of acetone and isopropanol levels in the blood of the deceased for medico-legal testimony

Borowska-Solonynko¹,

Siwińska-Ziółkowska²,

Piotrkowicz³

et al. 2014

amsik

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“…The authors assumed that the hyperketonemia that occurred during hypothermia was the result of the combined effect of hypoglycemia and the enhanced release of counter-regulatory hormones (glucagon, adrenaline, noradrenaline, cortisol, growth hormone), which intensify fat catabolism. In a study involving 16 cases of hypothermia [61], the authors observed an inverse relationship between blood ketone levels and the severity of insobriety due to the direct antiketonemic action of ethanol, which modifies cellular redox imbalance and prevents ketone production in the liver. Though increased blood ketone levels can be considered a diagnostic test of death by hypothermia, the authors emphasized that normal blood ketone concentrations would not exclude the diagnosis of hypothermia in cases that displayed ethanol in the blood.…”

Section: Ketone Bodiesmentioning

confidence: 99%

“…Teresiński et al [61][62][63] investigated ketone body blood levels as a biochemical marker of hypothermia and the usefulness of its determining to support the diagnosis of death by hypothermia. The authors assumed that the hyperketonemia that occurred during hypothermia was the result of the combined effect of hypoglycemia and the enhanced release of counter-regulatory hormones (glucagon, adrenaline, noradrenaline, cortisol, growth hormone), which intensify fat catabolism.…”

Section: Ketone Bodiesmentioning

confidence: 99%

Postmortem biochemical investigations in hypothermia fatalities

Palmière

Mangin

2012

Int J Legal Med

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Despite the progress made during the past several decades in forensic pathology, the possibilities for the postmortem diagnosis of hypothermia remains relatively limited. Aside from histology and immunohistochemistry, numerous authors have investigated the postmortem biochemistry of hypothermia fatalities. Several biochemical markers (e.g., glucose, electrolytes, hormones, ketone bodies, and neurotransmitters) and various biological samples (e.g., blood, urine, heart, liver, skeletal muscle as well as pericardial and cerebrospinal fluids) have been proposed as potentially useful markers to improve the insufficient diagnostic efficacy of macroscopic and microscopic findings. The aim of this article is to review the medicolegal literature covering the postmortem biochemical investigations that are associated with hypothermia cases as well as report our own research results on this topic where possible.

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FT‐IR spectrometry analysis of plasma fatty acyl moieties selective mobilization during endurance exercise

Petibois¹,

Déléris²

2005

Biopolymers

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This study was designed to describe changes in plasma fatty acyl moieties during a 2-h endurance exercise. Sixteen endurance-trained subjects cycled 2 h at 55% of maximal power output and capillary blood was sampled every 15 min. Fourier-transform infrared (FT-IR) spectrometry was used to determine correlated changes between plasma fatty acyl moieties (FAM) structural characteristics and metabolic parameters (oxygen consumption, respiratory exchange ratio, glucose, lactate, TG, glycerol, and albumin). Opposite changes were found between carbohydrate and fatty acid metabolism during the second hour of exercise, i.e., a decrease of glucose and lactate concentrations while albumin, FAM, and TG increased. For fatty acid metabolism, FAM and TG did not showed the same pattern of changes at the end of exercise, i.e., TG remained constant after 90 min while FAM continued to increase. This late FAM concentration increase was correlated to the changes in albumin concentration and the nu C=C-H/nu(as) CH3 and nu(as) CH2/nu(as) CH3 ratios. These ratios clearly showed that FAM unsaturation increased while chain length decreased. It was hypothesized that PUFA from TG adipose lipolysis ketone bodies (beta-hydroxybutyric acid) from liver may have been released in higher amounts as glycogen stores became depleted after 90 min of exercise.

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The influence of ethanol on the level of ketone bodies in hypothermia

Cited by 46 publications

References 21 publications

Analysis of the origin and importance of acetone and isopropanol levels in the blood of the deceased for medico-legal testimony

Analysis of the origin and importance of acetone and isopropanol levels in the blood of the deceased for medico-legal testimony

Postmortem biochemical investigations in hypothermia fatalities

FT‐IR spectrometry analysis of plasma fatty acyl moieties selective mobilization during endurance exercise

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