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β-hydroxybutyrate as a biomarker of β-cell function in new-onset type 2 diabetes and its association with treatment response at 6 months - 25/01/23

Doi : 10.1016/j.diabet.2023.101427 
Minyoung Lee 1, 2, #, Yongin Cho 3, #, Yong-ho Lee 1, 2, Eun Seok Kang 1, 2, Bong-soo Cha 1, 2, Byung-Wan Lee 1, 2,
1 Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea 
2 Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea 
3 Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea 

Address for correspondence: Byung-Wan Lee, Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea, Telephone: +82 2 2228 1938, Fax: +82 2 393 6884.Division of Endocrinology and Metabolism, Department of Internal MedicineYonsei University College of Medicine50-1, Yonsei-ro, Seodaemun-guRepublic of KoreaSeoul03722
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Highlights

Higher serum βHB level was associated with hyperglycemia and impaired insulin secretion at baseline.
Despite its association with deteriorated glucometabolic parameters at initial diagnosis, serum βHB level was an independent predictive marker for a greater improvement in hyperglycemia after 6 months of antidiabetic treatment.
Patients with higher initial serum βHB levels were more likely to have well-controlled HbA1c levels (≤6.5%) after 6 months of anti-diabetic treatment.

Le texte complet de cet article est disponible en PDF.

Abstract

Aims

Increasing attention has been paid to the potential metabolic benefits of ketone bodies, but the clinical relevance of ketone bodies in newly diagnosed type 2 diabetes mellitus (T2D) remains unclear. We investigated the clinical implications of ketone bodies at the time of diagnosis in patients with drug-naïve T2D.

Methods

Clinical data including serum β-hydroxybutyrate (βHB) levels, were collected from 369 patients with newly diagnosed drug-naïve T2D from 2017–2021. Subjects were categorized into four βHB groups based on the level of initial serum βHB. The associations of initial serum βHB and urinary ketone levels with glucometabolic indices were analyzed.

Results

Higher serum βHB group was associated with higher levels of glycemic parameters including glycated hemoglobin (HbA1c) with lower levels of indices for insulin secretory function at the point of initial diagnosis of T2D. Nevertheless, higher serum βHB group was an independent determinant of a greater relative improvement in HbA1c after 6 months of anti-diabetic treatment, regardless of the type of anti-diabetic drug. In addition, patients in higher serum βHB group were more likely to have well-controlled HbA1c levels (≤6.5%) after 6 months of anti-diabetic treatment.

Conclusion

In patients with newly diagnosed T2D, a higher initial βHB level was a significant predictive marker of greater glycemic improvement after antidiabetic treatment, despite its associations with hyperglycemia and decreased insulin secretion at baseline.

Le texte complet de cet article est disponible en PDF.

Key words : β-hydroxybutyrate, Biomarker, Ketone body, Type 2 diabetes


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© 2023  Publié par Elsevier Masson SAS.
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