Relationship between skin acetone and blood beta-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.