ACTA ENDOCRINOLOGICA (BUC)

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