α-Hydroxybutyrate Dehydrogenase (HBDH)

What sample is needed for α-Hydroxybutyrate Dehydrogenase?

1. This is done on the patient’s serum.
2. Separate serum as soon as possible.
3. Avoid hemolysis and use a clear serum.
4. Plasma Is not recommended.

What are the Indications for α-Hydroxybutyrate Dehydrogenase?

• For the diagnosis of myocardial infarction.

How will you define α-Hydroxybutyrate dehydrogenase?

1. α-Hydroxybutyrate Dehydrogenase is an isoenzyme of lactate dehydrogenase found in various tissues, with the highest concentration in the myocardium.
2. It is a marker for acute myocardial infarction.

How will you discuss the pathophysiology of α-Hydroxybutyrate Dehydrogenase?

1. The HBDH is an alternate to determine the  LDH isoenzymes (LDH-1).
2. HBDH indirectly measures LDH-1 of heart activity.
3. HBDH is cheaper than the LDH isoenzyme assay.
4. Roasalki and Wilkinson advocated the ratio of LDH/HBDH.
   1. In healthy individual serum, the ratio of LDH/HBDH varies from 1.2 to 1.6.
   2. In liver parenchymal diseases, it is 1.6 to 2.5.
   3. In heart disease (Myocardial infarction), when LDH-1 and LDH-2 activity is increased and HBDH is also increased, the LDH/HBDH ratio decreases to 0.8 to 1.2.
   4. LDH/HBDH ratio is more popular in the UK than in the USA.
5. The level of HBDH is usually detected within 12 hours of the infarction.
6. The peak level is seen from 48 to 72 hours.

What is normal for α-Hydroxybutyrate Dehydrogenase?

• At 25 C = 68  to 135 U/L.
• At 30 C = 82 to 163 U/L.
• At 37 C = 96 to190 U/L.

What are the causes of increased α-Hydroxybutyrate Dehydrogenase?

1. Myocardial infarction. HBDH can be done to assess the damage to the heart muscles.
2. It is raised in liver cell damage.
   1. It is raised in hepatitis.
   2. It is raised in cirrhosis.
   3. It is raised in drug-induced liver cell injury.
3. It is also raised in kidney diseases.
4. Muscular dystrophy.
5. Megaloblastic anemia.
6. Disseminated metastasis. It can be a tumor marker for lung, liver, and colorectal carcinoma.

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