Abstract
The variations in blood ketone bodies (BKB), blood glucose (BG) and insulin were studied in 19 normal and 14 hypoglycemic children aged 4 months to 13 years during a 24 hour fast. Except in 4 patients (2 with hyperinsulinism, 2 with defect in ketogenesis), a significant and parallel increase in BKB was observed in controls and patients from Oh to 20h (in mmol/1, mean±SD) 0.20±0.16 at Oh, 1.54±1.26 at 15h, 3.05±1.45 at 20h, 3.87±1.48 at 24h. A significant progressive decrease in glucose levels was observed from Oh to 20h but not from 20h on (in mg/dl) 116±16.4 at Oh, 74.5±16 at 15h, 60±15.5 at 20h, 59.57±13 at 24h. A highly negative correlation between BKB and BG was found at each time of fasting (r≥-0.54, p<.001 with a large dispersion of BKB especially for the ones corresponding to the BG between 45 and 65 mg/dl (SD=1.75mM). This dispersion was consistently reduced in a homogenous age group 4-6 years presenting with similar glucose levels (SD=0.92mM). There was a positive correlation between age and BG from 21h on (r≥0.61, p≤0.01), and an inverse relationship between age and BKB from 15h on (r>-0.43, p<0.001). The same high inverse relationship between age and BKB was again observed when the variable of glucose level was factored out (r=-0.73, p<0.001) demonstrating that the variation in BKB is indeed related to age. These findings deserve attention for the interpretation of fasting BKB especially when used as an aid in the diagnosis of the various forms of childhood hypoglycemia, and hypoketotic states.
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Saudubray, J., Marsac, C., Coude, F. et al. 1181 PLASMA KETONE BODIES DURING A 24-HOUR FAST IN NORMAL AND HVPOGLYCEMIC CHILDREN. RELATIONSHIP WITH AGE. Pediatr Res 15 (Suppl 4), 639 (1981). https://doi.org/10.1203/00006450-198104001-01207
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DOI: https://doi.org/10.1203/00006450-198104001-01207