Serum α-Hydroxybutyrate Dehydrogenase in Diagnosis

S. B. Rosalki, MD, MRCP; J. H. Wilkinson, PhD, DSc. FRIC
JAMA. 1964;189(1):61-63. doi:10.1001/jama.1964.03070010067019.
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THE SERUM LACTATE DEHYDROGENASE (LDH) has been much used for the diagnosis of myocardial infarction, but because of its lack of specificity it is often combined with isoenzyme studies.1 Of the five LDH isoenzymes, the electrophoretically fastest components, LDH1 and LDH2, characteristic of heart muscle, are preferentially increased after myocardial infarction; we have shown2 that these more readily reduce α-ketobutyrate than the slow-moving fractions, LDH4 and LDH5 found in the liver. This reduction of α-ketobutyrate has been termed "α-hydroxybutyrate dehydrogenase" (HBD) activity.3 We have shown that determination of the serum HBD activity provides a useful diagnostic test for myocardial infarction and eliminates the need for isoenzyme separation.4,5 As expected, raised serum HBD activities are not often encountered in liver diseases.6

The value of the new test has been confirmed.7-11 but as we have now had experience with it in 330


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