The differences of salivary and urine acetone levels in diabetes mellitus patients

Abstract

Ketone objects (acetone, beta-hydroxybutyric, acetoacetic acid) are compounds produced by the body from the breakdown of fatty acids (lipolysis) on the pathway of lipid metabolism. Synthesis of ketones can be caused by insulin hormone disorders such as those experienced by people with diabetes mellitus (DM). Such conditions trigger an increase in lipolysis in adipose tissue which results in the release of free fatty acids as a substrate for the process of ketogenesis in the liver. Acetone as a product of ketogenesis will enter the kidney to be excreted with urine, and if the amount is excessive, then some will accumulate into the saliva. The purpose of this research was to determine differences in salivary and urine acetone levels in DM patients. The type of research is analytic with the cross-sectional approach. Samples were taken using a sequential random sampling technique as many as 18 DM patients, both men and women aged 40-65 years old. The data collection technique was by conducting a direct examination of salivary and urine acetone which measured using spectrophotometric methods. The results showed an average salivary acetone level of 18.9 mg/L, while the mean level of urine acetone was 555.6 mg/L. Mann-Whitney statistical test showed a significance value of 0.000 (P <0.05), so it was concluded that there were significant differences between salivary acetone levels and urine acetone levels. Urine samples with smaller acetone concentrations are able to give positive results, while salivary samples will show positive results when acetone levels in urine are very high.