Measuring ketone bodies for the monitoring of pathologic and therapeutic ketosis.
Level 5 - mechanism / opinion, no new human data
Narrative literature review without systematic search or meta-analytic pooling
PubMed 34631141 · doi:10.1002/osp4.516
What was done
This narrative review synthesized literature on the metabolic pathways, typical concentration ranges, and clinical rationale for measuring ketone bodies—specifically blood β-hydroxybutyrate (BOHB) and breath acetone (BrAce)—across pathologic and therapeutic states, using bariatric surgery as a representative case study.
What was found
In healthy individuals, baseline ketone levels are approximately 0.1 mM for BOHB and ~1 part per million (ppm) for BrAce. In conditions such as heart failure and ketoacidosis, BOHB can rise up to 30-fold and BrAce up to 1000-fold. The authors describe how elevating ketones through nutritional ketosis can serve as alternative fuel in conditions with impaired glucose utilization (e.g., diabetes, brain dysfunction, cancer) and how routine monitoring can verify adherence during weight-loss programs.
Why it matters
It establishes standard baseline versus elevated ranges for blood and breath ketone metrics, outlining how accessible ketone testing may help tailor metabolic therapy and monitor disease progression.
Limits
The abstract describes a non-systematic narrative review without defined search criteria, quality appraisal, or primary data collection. Quantitative diagnostic accuracy metrics (sensitivity, specificity) and direct clinical trial outcomes are not provided in the abstract.
Cited by
- supports In nutritional ketosis, glucose and insulin are maintained at regulated levels with ketones typically ranging from 0.3 to around 5 millimolar.