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transaminitis in patients with dka

Sanjeet G Patel, Jean W Hsu, Farook Jahoor, Ivonne Coraza, James R Bain, Robert D Stevens, Dinakar Iyer, Ramaswami Nalini, Kerem Ozer, Christiane S Hampe, Christopher B Newgard, Ashok Balasubramanyam
A⁻β⁺ ketosis-prone diabetes (KPD) is an emerging syndrome of obesity, unprovoked ketoacidosis, reversible β-cell dysfunction, and near-normoglycemic remission. We combined metabolomics with targeted kinetic measurements to investigate its pathophysiology. Fasting plasma fatty acids, acylcarnitines, and amino acids were quantified in 20 KPD patients compared with 19 nondiabetic control subjects. Unique signatures in KPD--higher glutamate but lower glutamine and citrulline concentrations, increased β-hydroxybutyryl-carnitine, decreased isovaleryl-carnitine (a leucine catabolite), and decreased tricarboxylic acid (TCA) cycle intermediates--generated hypotheses that were tested through stable isotope/mass spectrometry protocols in nine new-onset, stable KPD patients compared with seven nondiabetic control subjects...
March 2013: Diabetes
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