Effect of hyperketonemia on plasma lipid peroxidation levels in diabetic patients

OBJECTIVE - This study uas undertaken to examine the effect of ketosis on p lasma lipid peroxidation levels in diabetic patients. RESEARCH DESIGN AND METHODS - Plasma levels of lipid peroxidation products (malondialdehyde) and ketone bodies (acetoacetate and beta-hydroxybutyrate) were determined in diabetic patients (n = 70) and age-matched normal volun teers (n = 25). Diabetic patients with total ketone body level >1.0 mmol/l were considered hyperketonemic, and those with levels less than or equal to 1.0 mmol/l were considered normoketonemic. RESULTS - After normalization versus total lipids, levels of lipid peroxida tion were significantly higher in the plasma of hyperketonemic diabetic pat ients (P < 0.05), but not in normoketonemic diabetic patients, compared wit h age-marched normal volunteers. In addition, low keronemia was associated with lower lipid peroxidation levels when lipid peroxidation and ketonemia were determined in the same patient (n = 7) at two different clinic visits. CONCLUSIONS - This study demonstrated an association between hyperketonemia and increased lipid peroxidation levels in diabetic patients, which sugges ts that ketosis is a risk factor in the elevated lipid peroxidation levels associated with diabetes. Further investigation is needed to determine whet her antioxidant supplementation can be particularly beneficial in reducing lipid peroxidation and complications in ripe 1 diabetic patients who freque ntly encounter ketosis.