Asetemia

Asetemia refers to the presence of acetone, acetoacetate, and β-hydroxybutyrate—collectively known as ketone bodies—in the blood. These compounds are byproducts of fat metabolism and are typically produced when the body lacks sufficient glucose for energy, prompting it to break down fats instead. While ketones are normally present in small amounts, elevated levels (ketonemia) can indicate an underlying metabolic imbalance.

The condition may arise in various clinical scenarios, including prolonged fasting, uncontrolled diabetes mellitus (particularly type 1), severe starvation, or conditions like diabetic ketoacidosis (DKA) and alcoholic ketoacidosis. In diabetic ketoacidosis, insulin deficiency prevents glucose utilization, leading to excessive fat breakdown and ketone accumulation. Alcoholic ketoacidosis, though less common, occurs in heavy alcohol users due to disrupted carbohydrate metabolism and alcohol-induced liver dysfunction.

Symptoms of asetemia may include nausea, vomiting, abdominal pain, shortness of breath, and a fruity odor on the breath (due to acetone exhalation). Severe cases can progress to metabolic acidosis, causing confusion, lethargy, or even coma if untreated. Diagnosis often involves blood or urine tests to measure ketone levels, alongside assessments of blood glucose and electrolyte imbalances.

Management typically involves addressing the root cause, such as insulin therapy for diabetes, rehydration, and electrolyte correction. In mild cases, dietary adjustments or short-term fasting cessation may suffice. Prognosis depends on early intervention and underlying health conditions, with prompt medical attention critical in severe cases to prevent complications like organ failure or neurological damage.