Beta-Hydroxybutyrate LiquiColor Assay from EKF Diagnostics

The Stanbio Chemistry LiquiColor® Beta-Hydroxybutyrate (BHB) reagent is used to detect ketones to identify patients suffering from diabetic ketoacidosis, amongst many other clinical applications.

Beta-Hydroxybutyrate is the most predominate ketone present during DKA and trends with a patient’s clinical status. Since the BHB assay is quantitative it can be used for monitoring ketosis to resolution, making it the superior ketone test.

Our Beta-Hydroxybutyrate reagent is used by over 1,100 hospitals in the USA and can be run on an open channel of a laboratory analyzer.

In addition, Beta-Hydroxybutyrate can be used to clinically diagnose and monitor the disease status or severity of alcoholism, glycogen storage disease, high fat/low carbohydrate diets, pregnancy, alkalosis, ingestion of isopropyl alcohol, and salicylate poisoning.


Beta-Hydroxybutyrate LiquiColor specification


Key Features


Reference No.

Beta-Hydroxybutyrate Dehydrogenase / INT

Ready-to-use liquid reagents
Working reagent stable up to 2 weeks @ 2­8 °C
Linear to 4.5 mmol/L
Read @ 505 nm

R1: 1 x 50 mL

R2: 1 x 8.5 mL

STD: 1 x 3 mL (1 mmol/L)



Beta-Hydroxybutyrate Liquicolor Test (Beckman Synchron CX/LX/DX)


Key Features


Reference No.

Beta-Hydroxybutyrate Dehydrogenase / INT

Instrument specific linearity

Read @ 520 nm

2 x 90 tests



Diabetic ketoacidosis

People with type 1 diabetes may be at risk when they do not have enough insulin, a hormone the body uses to break down sugar (glucose) in the blood for energy. When the body senses glucose is not available, fat is broken down instead.

As fats are broken down, acids called ketones build up in the blood and urine. Ketones are poisonous in high levels. This condition is called ketoacidosis.

Blood glucose levels rise (usually higher than 300 mg/dL) because the liver makes glucose to try to combat the problem. However the cells cannot pull in that glucose without insulin.

Symptoms can include rapid deep breathing, dry skin and mouth, flushed face, fruity smelling breath, nausea, vomiting and stomach pain.

Other symptoms that can occur are; Abdominal pain, breathing difficulty while lying down, decreased appetite, decreased consciousness, muscle stiffness and aches, dulled senses that may worsen to a coma and frequent urination and thirst that lasts throughout the day.

Beta-Hydroxybutyrate diagnosing Ketosis

When the body begins to break down its stored fats in response to a low supply of energy (glucose) it produces the ketone Beta-Hydroxybutyrate (BHB), which is further catabolised into acetoacetate and then into acetone.

Ketones (like glucose) can be tested or monitored in either urine or blood. Many hospitals still use Acetest or Ketostix for detecting and monitoring ketosis and ketoacidosis. This nitroprusside urine method produces a qualitative assessment of ketosis and ketoacidosis by detecting both acetoacetate and acetone. However nitroprusside methods do not detect Beta-Hydroxybutyrate.

Beta-Hydroxybutyrate is a better test for ketosis and ketoacidosis than nitroprusside methods for a number of reasons:

  • The nitroprusside method detects less than 22% of the ketones present in ketosis. Beta-Hydroxybutyrate is the main ketone produced by the body (78%).
  • Beta-Hydroxybutyrate demonstrates excellent stability, making it the most reliable indicator of clinically relevant ketosis and ketoacidosis.
  • During ketosis, Beta-Hydroxybutyrate levels increase more than levels of acetone and acetoacetate, clearly indicating the patient's trend in metabolic status.
  • Quantitative, objective Beta-Hydroxybutyrate results provide a better tool for differentiating metabolic acidosis and monitoring therapy.

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