January - March 2025, Volume 21, Issue 1

Yucel C, Y Yuzbasioglu, Katirci Y, Ertugrul MS, Comertpay E

Levels of Copeptin and Beta-Hydroxy Butyrate in Diabetic Ketoacidosis

Acta Endo (Buc) 2025, 21 (1): 17-22
doi: 10.4183/aeb.2025.17

Introduction. Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus, characterized by hyperglycemia, ketosis, and metabolic acidosis. This study aimed to evaluate blood and urine levels of copeptin and β-OHB in patients with DKA. Patients and methods. 49 patients with DKA and 30 healthy controls were included in the study. Serum and urine β-OHB and copeptin levels were measured using ELISA. Statistical analysis included Mann-Whitney U test, t-test, and ROC curve analysis to assess diagnostic performance. Results. Compared with controls, patients with DKA demonstrated significantly higher serum and urine β-OHB levels (p < 0.001) and lower serum copeptin levels (p < 0.001), while urine copeptin did not differ significantly (p = 0.456). Serum copeptin showed high sensitivity (98.0%) but limited specificity, whereas urine copeptin had low diagnostic value. Discussion. This study confirms β-OHB as a reliable biomarker for diagnosing DKA, with urine β-OHB offering a rapid and non-invasive alternative. Copeptin did not demonstrate diagnostic discrimination between DKA and healthy subjects. Conclusion. Quantitative measurement of serum and urine β-OHB provides superior diagnostic accuracy in DKA and should be incorporated into emergency diagnostic pathways. Copeptin may complement β-OHB in monitoring fluid status

Keywords: diabetes mellitus, diabetic ketoacidosis, beta-hydroxybutyrate, copeptin.

Correspondence: Cigdem Yucel, University of Health Sciences, Ankara Gulhane Training and Research Hospital, Ankara, 06018, Turkiye, E-mail: yucelcigdem80@gmail.com