Relationship between skin acetone and blood β-hydroxybutyrate concentrations in diabetes

Background: Acetone is emitted from the skin and acetone concentrations correlate with blood beta-hydroxybutyrate. Methods: Skin acetone concentrations of 63 patients with diabetes and 32 control subjects were measured by cold trapping followed by gas chromatography. Results: Skin acetone concentrations of patients with diabetes (188 +/- 17 ppb; mean +/- SE) were significantly higher than those of the control subjects (87 +/- 10 ppb, p < 0.01). There was no significant difference in skin acetone concentrations among patients with diabetes with regard to mode of treatment. Skin acetone concentrations were correlated with blood beta-hydroxybutyrate (r=0.669, p < 0.01), blood glucose (r=0.608,p < 0.01), and HbA1c (r=0.292,p < 0.05) in patients with diabetes. Skin acetone concentration was high (940 ppb) in a patient with diabetic ketoacidosis, and it fell to 80 ppb after insulin therapy. Conclusion: Measurement of skin acetone can be used as a screening test for ketoacidosis provided the analytical methods and tools become simpler. Moreover, it could become a marker of diabetic control and of ketone production in diabetes and other ketogenic conditions. (c) 2005 Elsevier B.V. All rights reserved.