Changes of the plasma ketone body level and arterial ketone body ratio at the onset of mild aneurysmal subarachnoid hemorrhage

The purpose of this study was to investigate the physiologic changes of ketone bodies in patients with aneurysmal subarachnoid hemorrhage. We tested the hypothesis that the plasma ketone bodies are associated with the vasoconstrictor and lipolysis effect of circulating catecholamine.Twenty-four patients with mild aneurysmal subarachnoid hemorrhage and 18 healthy volunteers were enrolled in this study. We collected arterial blood samples immediately after admission and 30 days later to measure the levels of 3-hydroxybutyrate, acetoacetate, epinephrine and norepinephrine.At the onset of aneurysmal subarachnoid hemorrhage, the plasma ketone body (3-hydroxybutyrate + acetoacetate) level and the epinephrine and norepinephrine concentrations were significantly elevated, but the arterial ketone body ratio (acetoacetate/3-hydroxybutyrate) was significantly decreased compared with that of the control group. There was a negative correlation between the plasma ketone body level and the arterial ketone body ratio. There was a positive correlation between the plasma ketone body level and epinephrine level. Thirty days after admission, the ketone body, epinephrine and norepinephrine levels, as well as the arterial ketone body ratio, showed no significant differences between the patients and controls.At the onset of mild aneurysmal subarachnoid hemorrhage, the plasma ketone body level was significantly increased, while the arterial ketone body ratio was significantly decreased.