Serum hydroxybutyrate dehydrogenase (HBD) assays in the clinical laboratory

Measurement of serum hydroxybutyrate dehydrogenase (HBD) activity for suspected myocardial infarction will nowadays usually be carried out with a commercially available test kit. Four such kits have been compared and evaluated: British Drug Houses HBDH set, Boehringer Corporation LDH-1-Iso-enzyme ;alpha-HBDH' kit, Calbiochem alpha-HBDH Statpack, and Eskalab alpha-HBDH reagent tablets. Of the 100 sera examined, 60 were from patients believed to have suffered a recent myocardial infarction, and 40 samples were from patients aged between 45 and 65 years who had no known hepatic, renal, or cardiac pathology, these being used to determine the normal range for each kit. Under standardized conditions the activity found differed from kit to kit; the clinical value of the various assay systems in terms of their ability to discriminate between normal and pathological sera is assessed; and finally the cost and the convenience of use of each kit procedure are discussed. Theoretical and experimental evidence is provided in support of an assay temperature of 30 degrees C, and a plea is made for international agreement on enzyme assay conditions.