Enzymatic 2-Hydroxybutyrate Measurement for Dysglycemia Screening Beyond Conventional Fasting Measures
Authors' conclusion
Enzymatic 2-HB measurement may serve as a screening biomarker to rule out postprandial dysglycemia in individuals with normal FPG and HbA1c.
Study context
- Population
- Biomarkers of Personalized Medicine cohort; prespecified subcohort with fasting plasma glucose (FPG) <110 mg/dL and HbA1c <39 mmol/mol (5.7%)534 with normal FPG and HbA1c
- Participants
- 772 participants
- Outcome
- Incremental discrimination of dysglycemia by fasting 2-HB beyond routine fasting measures; postprandial dysglycemia (2-h glucose >140 mg/dL during OGTT) in subcohort
Methodological detailsprespecified subcohort
- Prespecified subcohort
Performance
As reported in the abstract
| Test or model | AUC | Sensitivity at 39 µmol/L | NPV |
|---|---|---|---|
| 2-HB | 0.79 | 90% | 98.9% |
2-HB
AUC0.79
Sensitivity at 39 µmol/L90%
NPV98.9%
Further findings
| Outcome | OR | P value |
|---|---|---|
| Dysglycemia per 1-SD increase in 2-HBIndependently associated | 2.23 | P < 0.001 |
Fasting 2-HB by glycemic status
µmol/L
- 2-HB in normoglycemia
- 39.0
- 2-HB in prediabetes
- 51.9
- 2-HB in T2D
- 57.0
- n = 772
Original publication
Enzymatic 2-Hydroxybutyrate Measurement for Dysglycemia Screening Beyond Conventional Fasting Measures. Diabetes Care. Published 8 June 2026. doi:10.
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