Paper presented at the 63th Annual Meeting of the American Academy of Forensic Sciences February 25, 2011, in Chicago, IL.
Postmortem Vitreous Beta-Hydroxybutyrate: Interpretation in a Forensic Setting*
Article first published online: 27 MAR 2012
© 2012 American Academy of Forensic Sciences
Journal of Forensic Sciences
Volume 57, Issue 5, pages 1234–1240, September 2012
How to Cite
Heninger, M. (2012), Postmortem Vitreous Beta-Hydroxybutyrate: Interpretation in a Forensic Setting. Journal of Forensic Sciences, 57: 1234–1240. doi: 10.1111/j.1556-4029.2012.02121.x
- Issue published online: 5 SEP 2012
- Article first published online: 27 MAR 2012
- Received 6 Aug. 2010; and in revised form 4 May 2011; accepted 3 July 2011.
- forensic science;
- postmortem chemistry;
- death investigation;
- vitreous fluid;
Abstract: Vitreous beta-hydroxybutyrate (BHB) was retrospectively analyzed in 1795 forensic cases using the Pointe Scientific method. Comparison of vitreous BHB with vitreous glucose in 1781 of the cases showed moderately good correlation r = 0.731. Comparison with blood alcohol levels in 1561 of the cases showed no correlation r = −0.053. Vitreous BHB was a marker of diabetic ketoacidosis when above 6.0 mM with a vitreous glucose over 200 mg/dL. It was an indicator (>50%) for alcoholic ketoacidosis when above 6.0 mM with a vitreous glucose below 200 mg/dL. Recommendations for interpretation of vitreous BHB: <0.4 mM normal; 0.41–1.2 mM slightly elevated, rarely (<1%) of concern; 1.21–2.0 mM moderately elevated, less rarely (2.5%) of concern; 2.01–6.0 mM significantly elevated, frequently of concern (12–48%); >6.0 mM usually (100% in this study) indicated life-threatening conditions. Vitreous BHB was helpful evaluating cases with ketogenic conditions, especially diabetes and alcoholism.