Korean J Fam Pract. 2018; 8(3): 417-422  https://doi.org/10.21215/kjfp.2018.8.3.417
Relationship Ketonuria and Dyslipidemia in Korean Adults Aged 20 Years and Older
Ah-rana Kim, Ji-Hye Kim, Dong-Hyuk Jung*
Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
Dong-Hyuk Jung
Tel: +82-31-331-8821, Fax: +82-31-331-8709
E-mail: balsan2@yuhs.ac
ORCID: http://orcid.org/0000-0002-3411-0676
Received: May 31, 2017; Revised: August 7, 2017; Accepted: August 15, 2017; Published online: June 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: In various studies, the presence of ketonuria after at least an 8-hr fast is known to be possibly indicative of metabolic superiority. All metabolic parameters (including body weight, waist circumference, fasting glucose level, blood pressure, insulin level, high-density lipoprotein level, and triglyceride level) were more favorable in the ketonuria group than in the non-ketonuria group. In this study, we investigated the association between ketonuria and dyslipidemia.
Methods: We analyzed data from the 2013–2015 Korea National Health and Nutrition Examination Survey. Of the 17,780 people who participated in the survey, 9,269 were selected. The relationship of ketonuria with dyslipidemia was assessed using multivariable logistic regression analysis.
Results: The prevalence of dyslipidemia in the ketonuria-positive group was statistically significantly lower than that in the non-ketonuria group. Of the study subjects, 11.2% had hypercholesterolemia, 10.1% had hypertriglyceridemia, 22.4% had hypo-high-density lipoprotein cholesterolemia, and 10% had higher-low-density lipoprotein cholesterolemia. Ketonuria was associated with a lower risk of hypertriglyceridemia (odds ratio 0.620, 95% confidence interval 0.430–0.896) and hypo-high-density lipoprotein cholesterolemia (odds ratio 0.714, 95% confidence interval 0.551–0.926), after adjusting for confounding variables.
Conclusion: The risk of dyslipidemia was lower in the ketonuria group than in the non-ketonuria group. The presence of ketonuria is associated with the prevalence of dyslipidemia and the development of hypertriglyceridemia and hypo-high-density lipoprotein cholesterolemia.
Keywords: Ketouria; Hypercholesterolemia; Hypertriglyceridemia; Dietary Fat
  1. Laffel L. Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes Metab Res Rev 1999; 15: 412-26.
  2. McGarry JD, Foster DW. Regulation of hepatic fatty acid oxidation and ketone body production. Annu Rev Biochem 1980; 49: 395-420.
    Pubmed CrossRef
  3. Musunuru K. Atherogenic dyslipidemia: cardiovascular risk and dietary intervention. Lipids 2010; 45: 907-14.
    Pubmed KoreaMed CrossRef
  4. Korean Society of Lipidology and Atherosclerosis Dyslipidemia. Dyslipidemia fact sheet in Korea 2015 [Internet]. Seoul: Korean Society of Lipidology and Atherosclerosis Dyslipidemia; 2015 [cited 2015 Dec 8].
    Available from: http://www.lipid.or.kr
  5. Ha KH, Kwon HS, Kim DJ. Epidemiologic characteristics of dyslipidemia in Korea. J Lipid Atheroscler 2015; 4: 93-9.
  6. Witztum JL, Steinberg D. Role of oxidized low density lipoprotein in atherogenesis. J Clin Invest 1991; 88: 1785-92.
    Pubmed KoreaMed CrossRef
  7. Shah PK, Kaul S, Nilsson J, Cercek B. Exploiting the vascular protective effects of high-density lipoprotein and its apolipoproteins: an idea whose time for testing is coming, part I. Circulation 2001; 104: 2376-83.
    Pubmed CrossRef
  8. Verschuren WM, Jacobs DR, Bloemberg BP, Kromhout D, Menotti A, Aravanis C, et al. Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study. JAMA 1995; 274: 131-6.
    Pubmed CrossRef
  9. Jung HW, Park IK. Evaluation of the clinical significance of Ketonuria. Lab Med Online 2012; 2: 15-9.
  10. Joo NS, Lee DJ, Kim KM, Kim BT, Kim CW, Kim KN, et al. Ketonuria after fasting may be related to the metabolic superiority. J Korean Med Sci 2010;25: 1771-6.
    Pubmed KoreaMed CrossRef
  11. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143-421.
  12. Mohammadiha H. Resistance to ketonuria and ketosis in obese subjects. Am J Clin Nutr 1974; 27: 1212-3.
    Pubmed CrossRef
  13. Kim HJ, Joo NS, Kim KM, Lee DJ, Kim SM. Different response of body weight change according to ketonuria after fasting in the healthy obese. J Korean Med Sci 2012; 27: 250-4.
    Pubmed KoreaMed CrossRef
  14. Kim MK, Park JH. Metabolic syndrome. J Korean Med Assoc 2012; 55:1005-13.
  15. Choi JS, Lee JE, Sang JE, Han KD, Huh Y, Nam HY, et al. A comparison of predictability of physician-diagnosed dyslipidemia according to increased blood pressure, blood sugar and waist circumference: a nationwide populationbased retrospective cohort study. Korean J Fam Pract 2017; 7: 137-43.
  16. Suk MH, Moon YJ, Park SW, Park CY, Shin YA. Maximal fat oxidation rate during exercise in Korean women with type 2 diabetes mellitus. Diabetes Metab J 2015; 39: 328-34.
    Pubmed KoreaMed CrossRef
  17. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008; 359: 229-41.
    Pubmed CrossRef
  18. Nordmann AJ, Nordmann A, Briel M, Keller U, Yancy WS Jr, Brehm BJ, et al. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 2006; 166: 285-93.
    Pubmed CrossRef
  19. Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women:the A TO Z Weight Loss Study: a randomized trial. JAMA 2007; 297: 969-77.
    Pubmed CrossRef

This Article

Author ORCID Information

Social Network Service