The (non)sense of routinely analyzing beta-hydroxybutyric acid in forensic toxicology casework

Ketoacidosis is a metabolic disturbance caused by an elevated blood level of the ketone bodies acetoacetate, acetone and beta-hydroxybutyric acid (BHB). These compounds are generated by the liver when there is insufficient glucose available. Under these circumstances, lipids −stored as triglycerides in fatty tissue- are an alternative energy source. During lipolysis, triglycerides are degraded into fatty acids, resulting in the generation of acetyl-CoA. This co-enzyme is converted into acetoacetate, a precursor molecule of BHB and acetone.

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