Abstract

Starvation, diabetes, alcoholism and hypothermia cause ketoacidosis in the human body; therefore, the cause of death can be determined by analyzing ketone bodies in the blood of the deceased. In the case of decomposition of the cadaver, however, since collecting intact blood is impossible, ketone body analysis is performed using the spleen. However, the index for diagnosing ketoacidosis is based on blood concentration, and its correlation with ketone bodies present in the spleen remains unknown. In particular, since decomposition proceeds rapidly during summer, when temperature and humidity are high, understanding the correlation between ketone bodies in the blood and spleen is important to estimate the state at the time of death from a decaying body. Therefore, in the present study, the correlation between ketone bodies in the blood and spleen of the deceased was explored. Ketone bodies (beta-hydroxybutyric acid [BHB] and acetone) in the blood and spleen were analyzed and compared from autopsies (>100 mg·L−1 BHB, blood basis) conducted at the Daejeon Forensic Research Institute from June to December 2021. Moreover, the concentration of ketone bodies in the spleen juice and tissues was compared assuming the scenario of extreme decomposition. Ketone retention concentration in the blood and spleen was positively correlated, and the ratio of BHB concentration in the spleen to BHB concentration in the blood ranged from 0.52 to 1.08 (mean = 0.85 ± 0.12), although the ratio may vary depending on the degree of decomposition of the corpse.