The relationship between carnitine and ketone body levels in diabetic children

Free carnitine was significantly (p less than 0.001) reduced both in the ketotic (29.7 +/- 3.4 nmol/ml) and in the ketoacidotic (24.6 +/- 1.4 nmol/ml) groups when compared to controls (50.0 +/- 2.4 nmol/ml). At the same time, acylcarnitine values in the ketotic (21.2 +/- 2.4 nmol/ml) and ketoacidotic (25.4 +/- 2.3 nmol/ml) groups were significantly above the control value (4.71 +/- 0.6 nmol/ml). There was no significant difference between the two ketotic groups in carnitine derivatives. The abnormal distribution of plasma free and acylcarnitines could be reversed by insulin treatment. There was an inverse correlation between ketone body levels and free carnitine in the ketotic (r = -0.71, p less than 0.02) and ketoacidotic group (r = -0.71, p less than 0.05). However, there was no correlation between ketone bodies and acylcarnitine and between free carnitine and acylcarnitines. We concluded that the increased acylation was only partly responsible for the reduction of free carnitine in diabetic ketosis.