Advisory Committee Chair
Karen Scott
Advisory Committee Members
Brandi Mccleskey
Elizabeth Gardner
Simon Elliott
Document Type
Thesis
Date of Award
1-1-2025
Degree Name by School
Master of Science in Forensic Science (MSFS) College of Arts and Sciences
Abstract
Ketoacidosis occurs when fatty acids are metabolized into ketone bodies in the liver and released into the bloodstream. This condition, which can be fatal, is commonly observed in diabetics, alcoholics, and individuals who experienced starvation or hypothermia. Although the ketone ß-hydroxybutyrate (BHB) is an accepted biomarker of ketoacidosis, the effects of preservatives on BHB concentrations in postmortem blood are unaddressed. The first aim of this research was to determine whether preservatives affect ketone levels as measured by a point-of-care device. Paired preserved and unpreserved blood samples were obtained from the Jefferson County morgue: preserved samples in grey top tubes and unpreserved samples in red top tubes. BHB was measured using an Abbott ketone meter with ß-ketone test strips. Due to variation observed between the ketone meter readings from the morgue and the red top tubes it was concluded that a factor other than preservatives was influencing the ketone meter readings. The second aim of this research was to determine whether the ketone meter was a viable point-of-care device for measuring BHB in blood samples during autopsy. Concentrations of BHB in previously tested paired postmortem blood samples were quantified using a GC-MS method validated according to ANSI/ASB 036 guidelines. Additionally, matrix stability and processed sample stability were assessed to ensure the accuracy and reliability of analysis in variable conditions. Although the ketone meter results may not be accurate, both the ketone meter and GC-MS were able to indicate if a significant BHB concentration was present. Further, unextracted BHB was stable at -20°C, 4°C, and 20°C for 90 days and processed BHB was stable for 72 hours at room temperature. The GC-MS method developed in this research was used to evaluate a case study for a decedent with no known medical history. The results revealed a clear case of ketoacidosis characterized by elevated glucose, acetone, and isopropyl alcohol levels, as well as a ketone meter reading greater than 2.5 mmol/L. The BHB levels were confirmed using the validated GC-MS method in triplicate to demonstrate the value of BHB analysis in determining the cause of death.
Recommended Citation
Murr, Kerry F., "An Investigation Into The Effects Of Preservatives On ß-Hydroxybutyrate Concentrations Measured By Commercial Ketone Meter And Gas Chromatography-Mass Spectrometry" (2025). All ETDs from UAB. 6874.
https://digitalcommons.library.uab.edu/etd-collection/6874
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