SI UNITS (recommended)

CONVENTIONAL UNITS


Synonym
propanone

Units of measurement
mmol/L, mg/L, mg/dL, mg/100mL, mg%, µg/mL


Synonyms

  • Dimethyl ketone
  • Propanone
  • β-Ketopropane
  • Ketone body (volatile ketone)
  • Acetone (standard clinical name)

Units of Measurement

mmol/L, mg/L, mg/dL, mg/100mL, mg%, µg/mL

Description

Acetone is one of the three major ketone bodies, along with:

  1. Acetoacetate (AcAc)
  2. β-Hydroxybutyrate (BHB)

Acetone is formed spontaneously by decarboxylation of acetoacetate and is the least abundant ketone body in the blood. It is volatile and excreted through:

  • Breath (fruity odor)
  • Urine
  • Lungs (primary route)

It serves more as a marker of ketosis rather than a metabolic fuel.

Clinically, acetone levels rise in states of:

  • Diabetic ketoacidosis (DKA)
  • Alcoholic ketoacidosis
  • Starvation/fasting ketosis
  • Low-carbohydrate or ketogenic diets
  • Isopropyl alcohol poisoning (important toxicology clue)

Physiological Role

Acetone itself does not contribute significantly to energy production.
It is a byproduct of ketone metabolism.

Formation pathway:
Acetoacetate → (spontaneous decarboxylation) → Acetone

It accumulates when:

  • NADH/NAD⁺ ratio is high
  • Acetoacetate production is excessive
  • Ketosis becomes prolonged or severe

Since it is volatile, it causes the characteristic “fruity breath odor” in DKA.

Clinical Significance

Elevated Acetone

Seen in:

  • Diabetic Ketoacidosis (DKA)
  • Alcoholic ketoacidosis
  • Starvation ketosis
  • Ketogenic diet
  • Pregnancy ketosis
  • Isopropyl alcohol ingestion (acetone is a major metabolite)

Low/Normal Acetone

Occurs in:

  • Normal metabolism
  • Early DKA (BHB predominates)
  • Adequate carbohydrate intake

Reference Intervals

(Tietz 8E + Mayo Clinic + IFCC verified)

SampleReference Range
Blood (serum)< 0.3 mmol/L (typical physiological level)
Ketonemia range0.3 – 1.0 mmol/L
Ketoacidosis range> 1.0 mmol/L
UrineNegative to trace in healthy individuals

Note: β-hydroxybutyrate is the preferred test in DKA because BHB rises first and much higher than acetone.

Toxicology Point: Isopropyl Alcohol Poisoning

In isopropanol ingestion:

  • Acetone rises sharply
  • Osmolar gap increases
  • Ketosis without acidosis
  • Glucose is normal

This helps differentiate isopropyl alcohol poisoning from DKA.

Units Description & Conversion Factors

Molecular Weight of Acetone ≈ 58.08 g/mol

Unit Meanings

UnitMeaning
mmol/Lmillimole per liter
mg/Lmilligram per liter
mg/dLmilligram per deciliter
mg/100mLsame as mg%
mg%milligram per 100 mL
µg/mLmicrogram per milliliter

Conversions

  • 1 mg/L = 0.001 mg/mL
  • mg/dL → mg/L: ×10
  • mg/dL → mmol/L:
    mmol/L=mg/dL5.808\text{mmol/L} = \frac{\text{mg/dL}}{5.808}mmol/L=5.808mg/dL​
  • mmol/L → mg/dL:
    mg/dL=mmol/L×5.808\text{mg/dL} = \text{mmol/L} \times 5.808mg/dL=mmol/L×5.808
  • µg/mL → mg/L: ×1
  • mg/L → µg/mL: ×1

(Since 1 mg/L = 1 µg/mL)

Analytical Notes

1) Breath Acetone

Fruity odor on breath is classic for:

  • DKA
  • Prolonged fasting
  • Ketogenic diet

Breath testing is used in ketogenic diet monitoring.

2) Urine Ketone Tests

Nitroprusside tests detect mainly Acetoacetate and Acetone,
NOT β-hydroxybutyrate.

Hence:

  • Negative urine ketones do NOT rule out DKA.
  • Serum BHB is preferred for diagnosis.

3) Sample Handling

Acetone is volatile — avoid prolonged sample exposure to air.

Clinical Pearls

  • In DKA, β-hydroxybutyrate rises first, not acetone.
  • Breath acetone correlates loosely with ketosis but is not diagnostic.
  • Isopropanol poisoning produces very high acetone without acidosis.
  • Urine ketone dipsticks largely reflect Acetoacetate and Acetone, not true ketone burden.

Interesting Fact

Acetone was one of the earliest organic compounds identified in human breath (1857).
Today, breath acetone is being explored as a non-invasive biomarker for fat oxidation and metabolic status.

SEO Unit Converter Text

Acetone unit converter for clinical laboratories. Convert acetone levels between mmol/L, mg/L, mg/dL, mg%, mg/100mL, and µg/mL using molecular weight–based formulas. Includes ketosis and ketoacidosis ranges and toxicology interpretation.

References

MedlinePlus — Ketone tests and breath acetone.

Tietz Clinical Chemistry and Molecular Diagnostics, 8th Edition — Ketone bodies and volatile metabolites.

Mayo Clinic Laboratories — Ketone Body Interpretation.

IFCC Guidelines — Ketone Testing & DKA.

ARUP Consult — DKA and ketone markers.

NELSON Toxicology — Isopropanol poisoning & acetone metabolism.

American Diabetes Association — DKA criteria.

Last updated: December 6, 2025

Reviewed by : Medical Review Board

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