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

BackgroundAcetone is emitted from the skin and acetone concentrations correlate with blood β-hydroxybutyrate.MethodsSkin acetone concentrations of 63 patients with diabetes and 32 control subjects were measured by cold trapping followed by gas chromatography.ResultsSkin 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 β-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.ConclusionMeasurement 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.