D-3-Hydroxybutyrate (Ranbut)

D-3-Hydroxybutyrate (Ranbut)High linearity and excellent sensitivity for thedetection of ketosis in humans and animals

D-3 hydroxybutyrate (Ranbut)Measures D-3 hydroxybutyrate for the detection of ketosis in humans and animals.What is Ketosis?When carbohydrates are not available, fat is utilised for energyproduction. Metabolism of fatty acids in the liver results in theproduction of ketone bodies, consisting of acetone (2%), acetoacetate(20%) and D-3-hydroxybutyrate (78%). Levels of ketone bodies inthe blood are elevated (ketosis) when synthesis exceeds breakdown.Very high levels can be toxic causing damage to the kidneys and liver.Monitoring for ketosis is important in several conditions in the humanand veterinary fields, such as diabetes, hypoglycaemia, dieting, epilepsy,severe illness or injury, sepsis and twin lamb disease.Ketone Body ProductionKetone body productionEnergy demandexceeds glucosesupplyWhy measure D-3 Hydroxybutyrate?The nitroprusside method of ketone detection, used insemi-quantitative dipstick tests (e.g. Ketostix® and Acetest®), detectsacetone and acetoacetate, but not D-3-hydroxybutyrate.Advantages over dipstick tests• D-3 hydroxybutyrate is the major ketone body in the blood.• During ketosis, D-3 hydroxybutyrate levels increase more thanlevels of acetone and acetoacetate, making D-3 hydroxybutyrate amore sensitive marker of ketosis.OHFatty AcidsAlternative oxidationOLiverCO 2• D-3 hydroxybutyrate is the most stable of the ketone bodies(7 days at +4 o C) - acetone and acetoacetate are unstable, soserious errors can arise if analysis is delayed.One kit satisfies the needs of alllaboratoriesThe Ranbut assay from Randox offers high linearity and excellentsensitivity for the detection of ketosis in humans and animals.CH 3-CH-CH 2-COOH CH 3-C-CH 2-COOH CH 3-C-CH 3D-3-Hydroxybutyrate Acetoacetate Acetone20%2%78%% Composition of ketone bodiesin the blood during ketosis

D-3 hydroxybutyrate (Ranbut) in humanhealthcareThe detection of ketosis is important in several human conditions.The most important use of Ranbut in humans is in the detection ofpotentially fatal ketoacidosis in diabetics.• Diabetic Ketoacidosis – is a serious complication of diabetesoccurring when blood sugar levels are consistently high and insulinlevels are severely low. Due to the lack of glucose entering the cellsthe body begins to use fat stores as an alternative source of energyas a result the body produces ketones. Symptoms of ketoacidosisinclude nausea, vomiting, abdominal pain and can even lead to comaof death if the individual is not treated immediately.• In alcoholic ketoacidosis, the ratio of D-3 hydroxybutyrate toacetoacetate is more than twice that in diabetic ketoacidosis.Therefore, monitoring levels of D-3 hydroxybutyrate is importantwhen making a differential diagnosis between these two conditions.• Severe injury, illness or sepsis - Many critically ill patients respond tostarvation by metabolising fats and proteins, which leads to musclewastage. Monitoring ketone body levels in these patients followingan overnight fast allows diagnosis of this problem. Ranbut may beused to identify patients likely to benefit from nutritional support.• Dieting - Monitoring D-3 hydroxybutyrate levels may be used tomonitor patients’ dietary compliance.• Childhood epilepsy - Regular monitoring of ketone body levels maybe beneficial in maintaining a correct (ketogenic) diet for the controlof epilepsy.• Ketotic Hypoglycemia – refers to any circumstance in whichhypoglycaemia is accompanied with ketosis. It is also used to definerecurrent episodes of hypoglycaemia with ketosis in young children.Delayed feeding is the most common cause among children withsymptoms including vomiting, lethargy, unresponsiveness and evenseizures. The detection of D-3-Hydroxybutyrate in the serum orplasma of infants may indicate ketotic hypoglycaemia.D-3 hydroxybutyrate (Ranbut) in veterinaryhealthcareKetosis occurs during times of high energy demand. In animals, energydemand is high during milk production, pregnancy and immediatelyafter birth.• In dairy cows, ketosis can cause decreased milk yields, weight loss,infertility, excitability, and loss of appetite. These symptoms can leadto financial loss, so regular monitoring of dairy cows for ketosis haseconomic benefits.• Pregnancy toxemia, also known as ketosis, is a metabolic diseasethat occurs in late pregnancy. It is most prevalent in ewes carryingtwo or more lambs or in very fat ewes. It is caused by a disturbancein carbohydrate usage in the animal. Ewes with ketosis are lethargicand have a poor appetite for one to two weeks at the end ofpregnancy.• In piglets, incorrect feeding at birth can lead to hypoglycaemia.Detection of ketosis will alert the farmer to the hypoglycaemia,allowing careful nutrition to return glucose levels to normal.What are the advantages of using Ranbut?• High linearity - Ranbut is linear to 5.75 mmol/l• High sensitivity - Ranbut can detect changes inconcentration as low as 0.1 mmol/l• Only kinetic method available for the measurement ofD-3 hydroxybutyrate making automation easier• Easy to use• Good stability of working reagents (7 days at +4°C)• Specific for D-3 hydroxybutyrate(the major circulating ketone body)• Measurement of ketones in serum rather than inurine helps eliminate the risk of false negatives due toinsensitivity and false positives due to drug interference• Quality controls and RIQAS EQA programme available• Application sheets available for most analysers

Reaction principle and automation3-hydroxybutyrate dehydrogenaseD-3 hydroxybutyrate + NAD + Acetoacetate + H + + NADHThe change in absorbance at 340 nm can be directly correlated with the D-3 hydroxybutyrate concentration.Performance characteristicsSample Type – Suitable for use with both serum and plasma samplesWide measuring range – 0.1mmol/l – 5.75 mmol/lRanbut (D-3 hydroxybutyrate)Excellent PrecisionWithin run precision Level 2 Level 3Mean (mmol/l) 0.324 1.17SD 0.012 0.044CV (%) 3.78 3.76n 20 20Total Precision Level 2 Level 3Mean (mmol/l) 0.324 1.17SD 0.017 0.059CV (%) 5.25 5.06n 20 20Excellent Sensitivity – 0.1mmol/lLimited Interference - Haemoglobin was tested up to 1 g/dl and wasfound not to interfereStandard – supplied with the kitExcellent correlation to standard methods – A correlation coefficient of0.995 was obtained with a competitor methodSuitable for both manual and automated use - Fully automated protocolsare available for a wide range of clinical analysers including the RX seriesHow to orderRanbut is currently available in the following pack sizes:Product description Size Cat. no.Ranbut 10 x 10 ml RB1007Ranbut 10 x 50 ml RB1008Technical supportTo ensure quality, all Randox reagents and controls are manufacturedin-house and undergo our own rigorous quality control proceduresregistered to the International Quality Standard ISO 9001. In-housedevelopment and manufacture ensures that our Technical Support divisionhas detailed knowledge of each Randox product. Technical Support isavailable to all Randox customers and includes access to procedureinformation 24 hours a day, 7 days a week.Bovine Chemistry Assayed Level 1 20 x 5 ml AL1027Bovine Chemistry Assayed Level 2 20 x 5 ml AN1026Bovine Chemistry Assayed Level 3 20 x 5 ml AE1032Assayed Chemistry Premium Plus Level 2 20 x 5 ml HN1530Assayed Chemistry Premium Plus Level 3 20 x 5 ml HE1532Assayed Chemistry Premium Plus Level 2 & 3 10 x 5 ml HS2611Randox Laboratories Limited, 55 Diamond Road, Crumlin, County Antrim, BT29 4QY, United KingdomT +44 (0) 28 9442 2413 F +44 (0) 28 9445 2912 E marketing@randox.com I www.randox.comDEC10 LT029Information correct at time of print. All Randox products are made in the UK.Randox Laboratories Limited is a company registered within Northern Ireland with company number N.I. 15738. VAT Registered Number: GB 353 030 400. Product availability may vary from country to country. Please contact your local Randox representative for information.