Blood Beta-hydroxybutyrate Research Articles

Efekt koncentrace beta-hydroxybutyrátu v krvi na reprodukci, produkci a zdraví krav v prvních týdnech po otelení

The constant monitoring of dairy cow metabolism is extremely important, especially in the period immediately after calving, when the animals face the consequences of negative energy balance. The concentration of beta-hydroxybutyrate is one of the reliable indicators of metabolic status. The aim of this work was to evaluate the effect of beta-hydroxybutyrate concentration in the blood on selected parameters of production, reproduction, and health of Holstein dairy cows. The limit for subclinical ketosis was set to >1.2 mmol/L of beta-hydroxybutyrate in blood. Furthermore, the effects of lactation number, season, and year of assessment were added to the model equation. The results showed that high beta-hydroxybutyrate concentration in blood is associated with poor reproduction parameters (worse insemination interval and service period) and lower milk production. However, the results were ambiguous in relation to the somatic cell count and the occurrence of selected diseases (mastitis and ovarian cysts). Moreover, the effect of seasonality on the evaluated parameters was also confirmed (P<0.05), while assessed years were similar in most parameters. It can be concluded that the assessment of beta-hydroxybutyrate concentration as an indicator of potential ketosis is important and can be a suitable parameter for routine monitoring as it influences milk production, reproduction, and cow's health.

Haemotobiochemical changes and management of post-partum fatty liver syndrome in Malabari goats

The fatty liver syndrome was confirmed by haemotobiochemical and hepatic ultrasonographic investigations in 12 Malabari goats within six weeks after kidding. Animals were divided into two groups with six does each which received two different treatments. Ketonex bolus, which contains nicotinic acid, disodium hydrogen phosphate, and live yeast was given to the goats in Group I. The animals in Group II received syrup Bexoliv, which contains tricholine citrate, methionine, inositol, vitamin E, biotin, selenium, silymarin, iron, copper, and B12. In addition to this, animals of both groups received glycerin orally. On the fifteenth day of treatment, the animals were reevaluated. Six apparently healthy adult female goats within six weeks of kidding were selected as control. Before treatment, the neutrophil count showed a significant increase and lymphocyte and monocyte counts showed a decrease in the study groups. Blood beta-hydroxybutyrate (βHB), serum non-esterified free fatty acids (NEFA) and serum urea nitrogen (SUN) levels showed a significant increase before treatment and reduced after treatment among both groups. Hepatic ultrasonography showed hyperechogenicity of parenchyma before treatment when compared to after treatment. The animals showed improvement with both treatments.

The Effect of Different Ketone Supplements on Blood Beta-hydroxybutyrate and Glucose in Healthy Individuals

Acute increases in blood beta-hydroxybutyrate (BHB) temporarily reduce blood glucose but therapeutic application has been limited due to the need for ketone infusion or severe dietary restriction. Recently developed exogenous ketone monoester supplements allow to acutely raise blood BHB without the need for other nutritional modifications or invasive procedures. However, unpleasant taste and the potential for gastrointestinal discomfort make adherence to a supplement regimen challenging. Two novel ketone supplements have been developed that promise an improved consumer experience but differ in their chemical properties; it is currently unknown how these affect blood BHB and blood glucose compared to the original ketone monoester supplement.

LBODP019 Vitamin D Levels In A Population With Type 2 Diabetes

Abstract Background Little is known about the impact of over-the-counter ketone supplementation, used by patients to promote weight loss, on ketosis and serum ketone values. Recent literature suggests that acute ingestion of exogenous ketones leads to increased blood beta-hydroxybutyrate and decreased blood glucose1. Clinical Case A 61-year-old man with a history of type 2 diabetes mellitus, atrial fibrillation, hypertension, and hyperlipidemia presented as a transfer to the neurocritical care ICU from an outside hospital for subarachnoid hemorrhage secondary to intracranial saccular aneurysm. His admission hemoglobin A1c was 9.9% (ref 4.4-5.6), blood glucose was 205 mg/dL (ref 70-99), beta-hydroxybutyrate was markedly elevated at 26.2 mg/dL (ref 0-3), and urinalysis showed 80mg/dL ketones (ref 0). Serum toxicology screen was notable for detectable acetone 8mg/dL (ref: none detected). His lactate was 2 mmol/L (ref 0.5-1.9), Cr 0.99mg/dL (0.67-1.17), and HCO3 22 mmol/L (ref 22-27). Arterial blood gas showed pH of 7.37 (ref 7.38-7.47), and an anion gap metabolic acidosis (AGMA) of 15 mmol/L (ref &amp;lt;12). Given the patient's profound ketosis, hyperglycemia, and mild AGMA, the patient was started on an insulin drip for presumed diabetic ketoacidosis (DKA). After 4 hours, the patient's anion gap had decreased to 12mmcol/L. The following day, he was transitioned to basal/bolus insulin, and underwent embolization of his cerebral aneurysm. After further recovery, Endocrinology was consulted for insulin recommendations. The patient denied any prior history of DKA or use of any SGLT2-inhibitors, and denied decreased oral intake or vomiting prior to admission. He did report taking ketone supplements, "Keto Strong: Ketogenic Weight Management – Advanced Formulation," two tabs (700mg "proprietary keto blend") BID for 2-3 years with ingredients listed as: sodium beta-hydroxybutyrate, calcium beta-hydroxybutyrate, magnesium beta-hydroxybutyrate, medium chain triglyceride oil, L-arginine, alpha-ketoglutaric acid, and 7-keto-dehydroepiandrosterone. Given a lack of acidosis, mild hyperglycemia, and mild lactic acidosis without risk factors for euglycemic DKA, it was suspected his profound ketosis out of proportion to clinical picture was secondary to ketone supplementation with a misdiagnosis of DKA. Conclusion This is one of the first cases to report profound ketosis in a hospitalized patient likely secondary to exogenous ketone supplementation. Ketosis secondary to nutritional supplementation should be considered once more common etiologies are ruled out. Additional research is needed to determine the role of exogenous ketone use on metabolism and glycemic control.

LBODP035 When Is Ketosis Just Ketosis?

Abstract Background Little is known about the impact of over-the-counter ketone supplementation, used by patients to promote weight loss, on ketosis and serum ketone values. Recent literature suggests that acute ingestion of exogenous ketones leads to increased blood beta-hydroxybutyrate and decreased blood glucose1. Clinical Case A 61-year-old man with a history of type 2 diabetes mellitus, atrial fibrillation, hypertension, and hyperlipidemia presented as a transfer to the neurocritical care ICU from an outside hospital for subarachnoid hemorrhage secondary to intracranial saccular aneurysm. His admission hemoglobin A1c was 9.9% (ref 4.4-5.6), blood glucose was 205 mg/dL (ref 70-99), beta-hydroxybutyrate was markedly elevated at 26.2 mg/dL (ref 0-3), and urinalysis showed 80mg/dL ketones (ref 0). Serum toxicology screen was notable for detectable acetone 8mg/dL (ref: none detected). His lactate was 2 mmol/L (ref 0.5-1.9), Cr 0.99mg/dL (0.67-1.17), and HCO3 22 mmol/L (ref 22-27). Arterial blood gas showed pH of 7.37 (ref 7.38-7.47), and an anion gap metabolic acidosis (AGMA) of 15 mmol/L (ref &amp;lt;12). Given the patient's profound ketosis, hyperglycemia, and mild AGMA, the patient was started on an insulin drip for presumed diabetic ketoacidosis (DKA). After 4 hours, the patient's anion gap had decreased to 12mmcol/L. The following day, he was transitioned to basal/bolus insulin, and underwent embolization of his cerebral aneurysm. After further recovery, Endocrinology was consulted for insulin recommendations. The patient denied any prior history of DKA or use of any SGLT2-inhibitors, and denied decreased oral intake or vomiting prior to admission. He did report taking ketone supplements, "Keto Strong: Ketogenic Weight Management – Advanced Formulation," two tabs (700mg "proprietary keto blend") BID for 2-3 years with ingredients listed as: sodium beta-hydroxybutyrate, calcium beta-hydroxybutyrate, magnesium beta-hydroxybutyrate, medium chain triglyceride oil, L-arginine, alpha-ketoglutaric acid, and 7-keto-dehydroepiandrosterone. Given a lack of acidosis, mild hyperglycemia, and mild lactic acidosis without risk factors for euglycemic DKA, it was suspected his profound ketosis out of proportion to clinical picture was secondary to ketone supplementation with a misdiagnosis of DKA. Conclusion This is one of the first cases to report profound ketosis in a hospitalized patient likely secondary to exogenous ketone supplementation. Ketosis secondary to nutritional supplementation should be considered once more common etiologies are ruled out. Additional research is needed to determine the role of exogenous ketone use on metabolism and glycemic control.

A Novel Powder Formulation of the Ketone Ester, Bis Hexanoyl (R)-1,3-Butanediol, Rapidly Increases Circulating ß-Hydroxybutyrate Concentrations in Healthy Adults

Objective: Growing interest in the metabolic state of ketosis has driven development of exogenous ketone products to induce ketosis without dietary changes. Bis hexanoyl (R)-1,3-butanediol (BH-BD) is a novel ketone ester which, when consumed, increases blood beta-hydroxybutyrate (BHB) concentrations. BH-BD is formulated as a powder or ready-to-drink (RTD) beverage; the relative efficacy of these formulations is unknown, but hypothesized to be equivalent. Methods: This randomized, observer-blinded, controlled, crossover decentralized study in healthy adults (n = 15, mean age = 33.7 years, mean BMI = 23.6 kg/m2) aimed to elucidate blood BHB and glucose concentrations before and 15, 30, 45, 60, 90 and 120 minutes following two serving sizes of reconstituted BH-BD powder (POW 25 g, POW 12.5 g), compared to a RTD BH-BD beverage (RTD 12.5 g), and a non-ketogenic control, all taken with a standard meal. Results: All BH-BD products were well tolerated and increased BHB, inducing nutritional ketosis (BHB ≥0.5 mM) after ∼15 minutes, relative to the control. BHB remained elevated 2 h post-consumption. The control did not increase BHB. Ketosis was dose responsive; peak BHB concentration and area under the curve (AUC) were two-fold greater with POW 25 g compared to POW 12.5 g and RTD 12.5 g. There were no differences in peak BHB and AUC between matched powder and RTD formulas. Blood glucose increased in all conditions following the meal but there were neither significant differences in lowest observed concentrations, nor consistent differences at each time point between conditions. These results demonstrate that both powdered and RTD BH-BD formulations similarly induce ketosis with no differences in glucose concentrations in healthy adults.

Diurnal variation of milk fatty acids in early-lactation Holstein cows with and without hyperketonemia

Estimates of milk constituents by Fourier-transform mid-infrared (FTIR) analysis have been shown to be a useful tool in monitoring energy deficit in early-lactation dairy cows. Our objectives were to describe the diurnal variation in milk fatty acids (FAs) and estimate the association of hyperketonemia with concentrations and diurnal patterns of FTIR estimates of milk FA. Blood samples were collected via jugular catheters bihourly for 5 d from multiparous Holstein cows (n = 28) enrolled between 3 and 9 days in milk. Milk samples were collected thrice daily at 0600, 1400, and 2200 h for d 2, 3, and 4 of the study period. Cows were retrospectively classified as hyperketonemic (HYK; n = 13) or non-HYK (n = 15) based on blood beta-hydroxybutyrate (bBHB) concentrations analyzed during the study period. Cows were classified as HYK if bBHB was ≥ 1.2 mmol/l for ≥ 50% (22/44) of bihourly timepoints; cows were classified as non-HYK if bBHB was ≥ 1.2 mmol/l for < 50% of bihourly timepoints. The HYK cows had bBHB ≥ 1.2 mmol/l for 31.4 ± 6.8 timepoints while the non-HYK cows had bBHB ≥ 1.2 mmol/l for 8.0 ± 3.9 timepoints. We used generalized linear mixed models to analyze concentrations of milk FA over time and differences between HYK groups. The relative percentage of de novo, mixed, and preformed FAs all followed diurnal patterns, however only the yield of preformed FA diurnally cycled, reaching a nadir at 0600 h and peaking at 1400 h. The yield per milking of preformed FA was also greater in the HYK cows than in the non-HYK cows. Oleic acid in milk followed a similar diurnal pattern to the yield of preformed FA, likely driving the cyclical nature of preformed FA. Finally, stearic acid was greater in HYK cows. Our results suggest that FTIR estimates of milk FA offer the potential to provide insight on the energy status of early-lactation cows, and when interested in understanding the absolute concentrations and yields of milk FA, diurnal variation should be considered.

Effects of Exogenous Ketones on Blood β-OHB and Glucose: A Systematic Review and Meta-Analysis

ObjectivesExogenous ketone (monoester or salt) supplements are increasingly being employed for a variety of research purposes and marketed amongst the general public for their ability to raise blood beta-hydroxybutyrate (β-OHB). Emerging research suggests a blood glucose-lowering effect of exogenous ketones. Here, we systematically review and meta-analyze the available evidence of trials reporting on exogenous ketones and blood glucose. MethodsWe searched 6 electronic databases on December 13, 2021 for trials of any length that reported on the use of exogenous ketones compared to a placebo. We pooled raw mean differences (MD) in (i) blood β-OHB and (ii) blood glucose using random-effects models, and explored differences in the effects of ketone salts compared to ketone monoesters. Publication bias and risk of bias were examined using funnel plots and Cochrane’s risk-of-bias tool, respectively. ResultsTwenty-eight trials including a total of 332 participants met inclusion criteria. There was no evidence for publication bias. Four trials were judged to be at low risk of bias with some concern for risk of bias in the remaining trials. Compared to placebo, consumption of exogenous ketones raised blood β-OHB (MD = 1.98 mM; 95% CI: 1.52 mM, 2.45 mM; P < 0.001) and decreased blood glucose (MD = –0.47 mM; 95% CI: –0.57 mM, –0.36 mM; P < 0.001) across the post-supplementation period of up to 300 minutes. Across both analyses, significantly greater effects were found following ingestion of ketone monoesters compared to ketone salts (P < 0.001). ConclusionsConsumption of exogenous ketone supplements leads to acutely increased blood β-OHB and decreased blood glucose. Ketone monoesters exert a more potent β-OHB-raising and glucose-lowering effect as compared to ketone salts. Funding SourcesMichael Smith Foundation for Health Research (MSFHR) Scholar Award.

Ketogenic Diet Modulates Neuroinflammation via Metabolites from Lactobacillus reuteri After Repetitive Mild Traumatic Brain Injury in Adolescent Mice.

Repetitive mild traumatic brain injury (rmTBI) is associated with a range of neural changes which is characterized by axonal injury and neuroinflammation. Ketogenic diet (KD) is regarded as a potential therapy for facilitating recovery after moderate-severe traumatic brain injury (TBI). However, its effect on rmTBI has not been fully studied. In this study, we evaluated the anti-neuroinflammation effects of KD after rmTBI in adolescent mice and explored the potential mechanisms. Experimentally, specific pathogen-free (SPF) adolescent male C57BL/6 mice received a sham surgery or repetitive mild controlled cortical impacts consecutively for 7days. The uninjured mice received the standard diet, and the mice with rmTBI were fed either the standard diet or KD for 7days. One week later, all mice were subjected to behavioral tests and experimental analysis. Results suggest that KD significantly increased blood beta-hydroxybutyrate (β-HB) levels and improved neurological function. KD also reduced white matter damage, microgliosis, and astrogliosis induced by rmTBI. Aryl hydrocarbon receptor (AHR) signaling pathway, which was mediated by indole-3-acetic acid (3-IAA) from Lactobacillus reuteri (L. reuteri) in gut and activated in microglia and astrocytes after rmTBI, was inhibited by KD. The expression level of the toll-like receptor 4 (TLR4)/myeloid differentiation primary response 88 (MyD88) in inflammatory cells, which mediates the NF-κB pathway, was also attenuated by KD. Taken together, our results indicated that KD can promote recovery following rmTBI in adolescent mice. KD may modulate neuroinflammation by altering L. reuteri in gut and its metabolites. The inhibition of indole/AHR pathway and the downregulation of TLR4/MyD88 may play a role in the beneficial effect of KD against neuroinflammation in rmTBI mice.

Metabolic profile and productivity of dairy Holstein cows milked by a pasture-based automatic milking system during early lactation: Effects of cow temperament and parity

This study aimed to evaluate the influence of temperament and parity on milk production and metabolic responses of Holstein cows in a pasture-based automatic milking system. Thirty-five primiparous and 58 multiparous cows were classified as ‘calm’, ‘intermediate’ or ‘reactive’ in each of the temperament tests conducted: milking reactivity (MR), race time (RT), flight speed, and flight distance. The milk yield and milk composition, as well as the blood biochemistry, were measured during the first 10 weeks of lactation. Primiparous cows produced less milk than multiparous cows (24.0 ± 0.8 vs. 34.2 ± 0.6 L/d, respectively, P ˂ 0.0001), while the serum beta-hydroxybutyrate concentration differences according to parity were not detected. Multiparous cows that were classified as ‘reactive’ on MR and RT tests produced 3 kg/d more milk and had greater concentrations of milk components than ‘calm’ cows (P ≤ 0.05). There was no such relation in primiparous cows. Also, cows scored ‘reactive’ on RT showed greater milking frequency (2.50 ± 0.05 vs. 2.35 ± 0.04 milking/d; P = 0.01) and blood beta-hydroxybutyrate concentrations (1.28 ± 0.09 vs. 0.92 ± 0.10 mmol/L; P = 0.04) than RT ‘calm’ cows. In conclusion, the cows' temperament was associated with milk production and metabolism, which depended on parity and the temperament tests used. Although productive performance was different between parities, lipomobilization was not.

Modified low ratio ketogenic therapy in the treatment of adults with super-refractory status epilepticus.

Induction of ketosis by manipulation of nutrition intake has been proposed as an adjunctive treatment for super-refractory status epilepticus (SRSE). However, the classical 4:1 ketogenic ratio may not meet the nutrition needs, specifically protein for critically ill adults. The aim of this study was to analyze the outcomes of adults with SRSE who received a lower ketogenic ratio of 2:1 grams of fat to non-fat grams, including 20%-30% of energy from medium chain triglycerides. We reviewed patients aged ≥18 years with SRSE treated with ketogenic therapy between July 2015 and December 2020 at two quaternary teaching hospitals in Melbourne, Australia. Data collected from medical records included patient demographics, nutrition prescription, clinical outcomes, and ketogenic therapy-related complications. The primary outcome of the study was to assess tolerability of ketogenic therapy. Twelve patients (female = 7) were treated with ketogenic therapy for SRSE. Patients received between 4 and 8 antiseizure medications and 1-5 anesthetic agents prior to commencement of ketogenic therapy. Blood beta-hydroxybutyrate concentrations were variable (median = 0.5 mmol/L, range: 0.0-6.1 mmol/L). SRSE resolved in 10 cases (83%) after a median of 9 days (range: 2-21 days) following commencement of ketogenic therapy. Ketogenic therapy-associated complications were reported in five patients, leading to cessation in two patients. Despite the challenge in maintaining ketosis during critical illness, low ratio 2:1 ketogenic therapy incorporating medium chain triglycerides is tolerable for adults with SRSE. Further studies are required to determine the optimal timing, nutrition prescription and duration of ketogenic therapy for SRSE treatment.

The Effects of Carbohydrate versus Fat Restriction on Lipid Profiles in Highly Trained, Recreational Distance Runners: A Randomized, Cross-Over Trial.

A growing number of endurance athletes have considered switching from a traditional high-carbohydrate/low-fat (HCLF) to a low-carbohydrate/high-fat (LCHF) eating pattern for health and performance reasons. However, few studies have examined how LCHF diets affect blood lipid profiles in highly-trained runners. In a randomized and counterbalanced, cross-over design, athletes (n = 7 men; VO2max: 61.9 ± 6.1 mL/kg/min) completed six weeks of two, ad libitum, LCHF (6/69/25% en carbohydrate/fat/protein) and HCLF (57/28/15% en carbohydrate/fat/protein) diets, separated by a two-week washout. Plasma was collected on days 4, 14, 28, and 42 during each condition and analyzed for: triglycerides (TG), LDL-C, HDL-C, total cholesterol (TC), VLDL, fasting glucose, and glycated hemoglobin (HbA1c). Capillary blood beta-hydroxybutyrate (BHB) was monitored during LCHF as a measure of ketosis. LCHF lowered plasma TG, VLDL, and TG/HDL-C (all p < 0.01). LCHF increased plasma TC, LDL-C, HDL-C, and TC/HDL-C (all p < 0.05). Plasma glucose and HbA1c were unaffected. Capillary BHB was modestly elevated throughout the LCHF condition (0.5 ± 0.05 mmol/L). Healthy, well-trained, normocholesterolemic runners consuming a LCHF diet demonstrated elevated circulating LDL-C and HDL-C concentrations, while concomitantly decreasing TG, VLDL, and TG/HDL-C ratio. The underlying mechanisms and implications of these adaptive responses in cholesterol should be explored.

The Association between Blood Β-Hydroxybutyric Acid Concentration in the Second Week of Lactation and Reproduction Performance of Lithuanian Black and White Cows.

Simple SummaryDetermination of BHB concentration in the second week of lactation (WK 2) may allow us to predict the fertility properties of cows and help better manage farms. BHB concentration can be considered as a predictor trait of reproduction success. High BHB concentration requires a higher amount of insemination. The season in which the cows calve and the parity must be considered in the assessment as these factors affect BHB concentration in WK 2.Hyperketonemia is a very common metabolic state in dairy cows, which result in lower milk production, impaired fertility, and increased frequency of other diseases. In this study, we aimed to determine the influence of season, parity, and milk yield of cows on beta-hydroxybutyrate (BHB) concentration in the second week of lactation (WK 2) and establish the relationship between BHB concentration in WK 2 and reproduction performance traits such as insemination rate and first insemination day of Lithuanian Black and White dairy cows. The study included clinically healthy Lithuanian Black and White cows (n = 692). Blood BHB concentration was measured using capillary blood samples collected after morning milking when cows were 7–10 DIM. The impact of WK 2 blood BHB concentration on the insemination rate and first insemination day were investigated. The effect of BHB was evaluated according to the season, parity, and milk yield per lactation (305 DIM). Significant differences were observed in BHB concentration in WK 2 due to season and parity, but no statistically significant differences were observed for milk yields (305 d). Increased blood BHB concentration in WK 2 negatively affected insemination rate (p < 0.001) and first insemination day (p < 0.001). The study findings indicate that BHB concentration in WK 2 depends on season and parity, while the milk yield is not associated with BHB concentration. High BHB concentration in WK 2 increases insemination rate and delays the first insemination day for high milk-yielding Lithuanian Black and White dairy cows.

Subclinical ketosis: Prevalence and risk factor analysis in early lactation dairy cattle of Thrissur district

Present study was conducted in Kerala Veterinary and Animal Sciences University farms, various organized and unorganised farms and individual households in Thrissur district during the period of May 2021 to April 2022 with the objectives of estimation of prevalence of subclinical ketosis (SCK) by screening dairy cows on 14th and 28th day post-partum. Multiparous cows with a blood beta-hydroxy butyrate (BHB) value ≥ 1.2 mmol/L without any overt clinical signs were considered as positive for SCK. One hundred and fourteen animals from second to seventh lactation were screened for SCK. Prevalence of SCK was 23.7 per cent on 14th day and 14.04 per cent on 28th day with a total prevalence of 27.2 per cent. Occurrence of SCK was highest in animals in second lactation (54.8 per cent) with more occurrence in crossbred Holstein Friesian cows. Maximum number of positive cases were observed in dairy cows of age between four to six years (54.8 per cent). Body condition score of diseased animals were higher than normal animals. Prevalence was highest in animals calved between months of July to September and 58.1 per cent of affected animals had male calf. Concurrent abnormalities during transition period were also assessed based on clinical examination and farm records.

Bis Hexanoyl (R)-1,3-Butanediol, a Novel Ketogenic Ester, Acutely Increases Circulating r- and s-ß-Hydroxybutyrate Concentrations in Healthy Adults

Background Ketosis has been reported to benefit healthspan and resilience, which has driven considerable interest in development of exogenous ketones to induce ketosis without dietary changes. Bis hexanoyl (R)-1,3-butanediol (BH-BD) is a novel ketone di-ester that can be used as a food ingredient that increases hepatic ketogenesis and blood beta-hydroxybutyrate (BHB) concentrations. Methods Here, we provide the first description of blood ketone and metabolite kinetics for up to five hours after consumption of a beverage containing BH-BD by healthy adults (n = 8) at rest in three randomized, cross-over conditions (25 g + Meal (FEDH); 12.5 g + Meal (FEDL) ; 25 g + Fasted (FASTH)). Results Consumption of BH-BD effectively raised plasma r-BHB concentrations to 0.8–1.7 mM in all conditions, and both peak r-BHB concentration and r-BHB area under the curve were greater with 25 g versus 12.5 g of BH-BD. Urinary excretion of r-BHB was <1 g. Plasma concentration of the non-physiological isoform s-BHB was increased to 20–60 µM in all conditions. BH-BD consumption decreased plasma glucose and free fatty acid concentrations; insulin was increased when BH-BD was consumed with a meal. Conclusions These results demonstrate that consumption of BH-BD effectively induces exogenous ketosis in healthy adults at rest.

A pilot monitoring strategy for post-partum disease in an Australian dairy herd

ABSTRACT Aims To design a monitoring strategy that could be applied to regular veterinary visits to dairy farms to assess the prevalence and association between health conditions (uterine disease, hyperketonaemia and suboptimal body condition score) when diagnosed and treated at 1–7 days post-calving (DPC) and then re-examined at 28–35 DPC. Methods This study evaluated data from 187 high-yielding dairy cows (21 primiparous, 166 multiparous) on one South Australian dairy farm on two occasions; Visit A which was 1–7 DPC and Visit B which was 28–35 DPC. On each visit, the nature of vaginal discharge, concentration of beta-hydroxybutyrate (BOH) in blood and BCS were recorded and assigned a clinical score. This was converted to a categorical outcome denoting the presence or absence of an abnormal health event, namely metritis or endometritis, hyperketonaemia (BOH concentration ≥1.2 mm/L) and suboptimal body condition score (>0.5 from optimum score). Cows with uterine disease or hyperketonaemia at either visit were treated. The prevalence of abnormal health events at each visit was determined and the association between the prevalence of disease at Visit A and Visit B (following appropriate treatment at Visit A) was measured using regression analysis. Results The prevalence of abnormal vaginal discharge, hyperketonaemia and suboptimal BCS at Visits A and B were 26%, 7%, 35% and 25%,16%, 33% respectively. A higher proportion of primiparous cows (Visit A: 0.86 (95% CI = 0.70–1.00); Visit B: 0.95 (95% CI = 0.86–1.00)) were found to have suboptimal BCS at both visits compared to multiparous cows (Visit A: 0.28 (95% CI = 0.20–0.35); Visit B: 0.24 (95% CI = 0.17–0.32)). A higher prevalence of hyperketonaemia at Visit B for multiparous compared to primiparous cows (19 (95% CI = 12–25)% vs. 0 (95% CI = 0–17) respectively) was identified. An increase in clinical discharge score at Visit A increased the odds of purulent vaginal discharge at Visit B (OR = 1.77 (95% CI = 1.31–2.40)). Failing to calve at target BCS was strongly associated with cows missing target BCS at Visit B (OR = 5.77 (95% CI = 2.35–13.11)) and for every unit increase in BCS at Visit A, BCS at Visit B increased by 0.40 (95% CI = 0.26–0.53). Conclusions and clinical relevance This study describes a pilot monitoring strategy for clinical parameters indicative of post-partum disease at 1–7 and 28–35 DPC. Determining the herd prevalence of these conditions will enable tracking of herd disease status over time. Abbreviations: BCS: Body condition score; BOH: Beta-hydroxybutyrate; DPC: Days post-calving; NEFA: Non-esterified fatty acids; SCHK: Subclinical hyperketonaemia

Blood pressure, body mass index lowering and ketogenesis in Qigong Bigu

BackgroundHypertension is one of the most common comorbid conditions of epilepsy. Hypertension and epilepsy may be related to each other. Qigong Bigu practice induces a similar effect as fasting in the first week. As ketogenesis is induced during ketogenic diet therapy, we hypothesize that ketogenesis is detectable and related body weight loss would occur during the first week of Qigong Bigu practice.MethodsDuring the prospective observational study, 34 healthy adult participants attended the Qigong Bigu practice for one week. The blood pressure, body weight, calorie consumption, blood glucose and beta-hydroxybutyrate level were measured.ResultsThe body weight and body mass index decreased by 2.39 ± 1.34 kg (95%CI 1.92–2.85) and 0.94 ± 0.57 (95%CI 0.73–1.15), respectively, after five days of practice (P < 0.001). The systolic and diastolic blood pressure decreased by 17.86 ± 14.17 mmHg (95%CI 12.36–23.35) and 9.75 ± 7.45 mmHg (95%CI 6.86–12.64), respectively (P < 0.001). The average five-day calorie consumption was 1197.47 ± 569.97 kcal (95%CI 998.60–1396.35). Meanwhile, no symptomatic hypoglycemia or other significant side effects were observed. The blood beta-hydroxybutyrate level increased to a nutritional level of 1.15 ± 1.12 mmol/L (95%CI 0.76–1.62). The calorie consumption negatively correlated to the beta-hydroxybutyrate level in the blood. The loss of body weight and the decrease of body mass index were positively correlated to the blood beta-hydroxybutyrate level.ConclusionsQigong Bigu can decrease the blood pressure, the body weight and the body mass index in healthy adult participants. The fasting stage of Qigong Bigu is accompanied by ketogenesis. Clinical trial of Qigong Bigu in hypertension and epilepsy patients might be worthwhile. The blood beta-hydroxybutyrate might be used as a biomarker to evaluate the effect of Qigong Bigu practice during fasting.Trial registrationChiCTR1800016923.

Developing a predictive model for beta-hydroxybutyrate and non-esterified fatty acids using milk fourier-transform infrared spectroscopy in dairy cows

Negative energy balance following parturition predisposes dairy cattle to numerous metabolic disorders. Current diagnostics are limited by their labor requirements and inability to measure multiple metabolic markers simultaneously. Fourier-transform Infrared spectroscopy (FTIR) data, measured from milk samples, could improve the detection of metabolic disorders using routine milk samples from dairy farms. The objective of this study was to develop a predictive model for numeric values of blood beta-hydroxybutyrate (BHB) and blood non-esterified fatty acids (NEFA). The study utilized a dataset comprised of 622 observations with known blood BHB and blood NEFA values measured concurrently with the milk FTIR data. Using ElasticNet regression on milk FTIR data and production information, we built regression models for numeric blood BHB and blood NEFA prediction and classification models for blood BHB values greater than 1.2 mmol/L and blood NEFA values greater than 0.7 mmol/L. The R2 of the best fitting model was 0.56 and 0.51 for log-transformed BHB and log-transformed NEFA, respectively. The BHB classification model had a 90 % sensitivity and 83 % specificity and the NEFA classification model achieved a sensitivity of 73 % and specificity of 74 %. We applied our numeric prediction models to an external dataset (n = 9660) with known blood metabolites to validate the prediction accuracy of log-transformed blood BHB and log-transformed blood NEFA models. Log-transformed BHB root mean square error (RMSE) was 0.4018 and log-transformed NEFA RMSE was 0.4043.The second objective of this study was to develop a categorization for cows as either metabolically disordered or healthy. Responses to negative energy balance in transition cows are related to blood levels of BHB and NEFA. Cows suffering from metabolic disorders without elevated blood BHB values remain unidentified when detection is focused on blood BHB alone. To account for this differentiated metabolic response, we categorized cows as either ‘metabolically healthy’ or suffering a ‘metabolic disorder’ by using a combination of blood BHB, blood NEFA, and milk fat to protein quotient. We obtained a balanced accuracy of 94 % for the prediction of cow metabolic status. Direct prediction of metabolic status can be used to identify hyperketonemic cows in addition to cows exhibiting metabolic response patterns not detected by elevated blood BHB alone.

Diagnosis of Ketosis in Postpartum Dairy Cows by Rapid On-Farm Tests in the Peri-Urban Area of Dakar, Senegal

The objective of this study is to contribute to the improvement of the productivity of dairy farms through the rapid detection of metabolic diseases of dairy cows on the farm. The study involved 42 dairy cows from a dairy farm located in the village of Niacoulrab. Four blood and urine samples were taken from each cow every two weeks for the first eight weeks after calving. Blood and urine ketone and glucose determinations and urine pH measurements were performed by FREESTYLE OPTIUM device, CUMBUR Test and pH paper during the first 8 weeks postpartum. The following results were obtained: the prevalence and incidence of subclinical ketosis were very high 45% and 32% respectively. At the 4th week of lactation, the blood concentration of Beta-Hydroxy-Butyrate was very high respectively 1.9 ± 0.31mmol/l and 4.2 ± 0.85 mmol/l in subclinical and clinical ketosis cows. At the 4th week of lactation, urinary acetoacetate concentration was very high in subclinical and clinical cows with values of 8.8 ± 2.3 mmol/l and 15 ± 3.8 mmol/l respectively. Blood glucose concentration was very low in subclinical and clinical ketosis cows with values of 0.37 ± 0.03 mmol/l and 0.2 ± 0.03 mmol/l respectively around the 4th week of lactation. There was a strong correlation between the concentrations of glucose (r2= -0.88) and Beta-HydroxyButyrate (-0.86) in blood and also with those of acetoacetate in urine.

Forage source (alfalfa hay vs wheat straw) and rumen undegradable to degradable protein ratio: Effects on growth performance, microbial protein yield, digestibility, blood metabolites, and behavior of Holstein dairy calves

Aim of the study: The effects of forage source (alfalfa hay; AH vs. wheat straw; WS) with rumen undegradable to degradable protein ratio [low ratio (LR) = 28:72; high ratio (HR) = 36:64] were evaluated in young dairy calves.Area of study: Arak, Iran.Material and methods: Forty-eight 3-d old female Holstein dairy calves (44.5 kg of BW) were allocated in four treatments: (1) AH with low dietary RUP:RDP ratio (AH-LR); (2) AH with high dietary RUP:RDP ratio (AH-HR); (3) WS with low dietary RUP:RDP ratio (WS-LR); and (4) WS with high dietary RUP:RDP ratio (WS-HR), being RDP and RUP rumen degradable and undegradable proteins, respectively. The calves weaned on d 53 of the experiment and remained in the study until d 73 of age.Main results: The average daily gain and feed efficiency were improved in dairy calves receiving HR diets compared to LR diets during the post-weaning period (p&lt;0.05). The fecal score (p=0.03) and neutral detergent fiber digestibility (p=0.04) were improved when calves fed WS diets compared to AH diets. Feeding HR diets increased allantoin (p=0.04) and microbial protein yield, and reduced blood urea nitrogen concentration (p=0.03) compared to LR diets. Assessing the interaction effects of the experimental factors resulted that the greatest BW, wither height, and blood beta-hydroxybutyrate, and the lowest urinary N concentration were observed in the WS-HR treatment (p&lt;0.05).Research highlights: Feeding WS with high RUP:RDP ratio is recommendable in dairy calves due to the improvement in gain and N efficiency.