{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:11:44Z","timestamp":1791231104127,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005703","name":"Akdeniz University Research Foundation","doi-asserted-by":"publisher","award":["TTU-2023-6470"],"award-info":[{"award-number":["TTU-2023-6470"]}],"id":[{"id":"10.13039\/501100005703","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathophysiology"],"abstract":"<jats:p>Background\/Objectives: Diabetic ketoacidosis (DKA) is an acute and severe complication of diabetes mellitus, marked by hyperglycemia, ketosis, and acidosis. It is associated with significant metabolic and inflammatory adjustments that can impact multiple biochemical pathways. This study aimed to determine the serum sphingolipid profile in DKA and investigate its relationship with neutral sphingomyelinase (N-SMase), pro-inflammatory cytokines, \u03b2-hydroxybutyrate (\u03b2-OHB), and lactate levels. Methods: Thirty-three participants were divided into three groups: control (BMI \u2264 30, no health issues), obese (BMI &gt; 30), and DKA (BMI \u2264 30). Sphingomyelins (16:0\u201324:0 SMs) and ceramides (C16\u2013C24 CERs) were measured using ultra-fast liquid chromatography combined with tandem mass spectrometry (LC-MS\/MS). N-SMase, interleukin 1 beta (IL-1\u03b2), and tumor necrosis factor alpha (TNF-\u03b1) levels were assessed by enzyme-linked immunosorbent assay. Evaluations were done in the DKA group before and after standard clinical treatment for DKA (post-DKA group), which included intravenous insulin therapy, fluid resuscitation, and electrolyte replacement, as per established clinical guidelines. Results: \u03b2-OHB levels were significantly higher in the DKA group than in the control, obese, and post-DKA groups. Although \u03b2-OHB levels decreased in the post-DKA group, they remained elevated compared to the control and obese groups. Lactate levels were also higher in the DKA group, with a significant decrease in the post-DKA group. TNF-\u03b1 and IL-1\u03b2 were higher in the obese group compared to control and DKA groups, and TNF-\u03b1 decreased significantly in the post-DKA group compared to DKA. N-SMase, 16:0\u201318:0 SMs, and C18-C24 CER levels were lower in the DKA and post-DKA groups compared to obese and control groups. Serum \u03b2-OHB and lactate levels were significantly correlated with S1P, total CER, total SM, and N-SMase values. Conclusions: The study reveals significant metabolic and inflammatory differences in DKA and post-DKA states, suggesting a relationship between sphingolipids, N-SMase, and these alterations, which could offer insights into DKA pathophysiology and therapeutic targets.<\/jats:p>","DOI":"10.3390\/pathophysiology32030029","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T11:15:23Z","timestamp":1750936523000},"page":"29","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diabetic Ketoacidosis Is Associated with Lower Serum Sphingolipids but Higher \u03b2-Hydroxybutyrate and Lactate: A Pilot Study"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9357-004X","authenticated-orcid":false,"given":"Ibrahim","family":"Aslan","sequence":"first","affiliation":[{"name":"Endocrinology Clinic, Antalya Research and Education Hospital, The University of Health Sciences, Antalya 07000, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8874-2241","authenticated-orcid":false,"given":"Tu\u011f\u00e7e","family":"\u00c7eker","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Akdeniz University Medical Faculty, Antalya 07000, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9307-3141","authenticated-orcid":false,"given":"Tayfun","family":"Ustaba\u015f","sequence":"additional","affiliation":[{"name":"Internal Medicine Clinic, Antalya Research and Education Hospital, The University of Health Sciences, Antalya 07000, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5697-8042","authenticated-orcid":false,"given":"Vuslat","family":"Zorlu","sequence":"additional","affiliation":[{"name":"Internal Medicine Clinic, Antalya Research and Education Hospital, The University of Health Sciences, Antalya 07000, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4880-5900","authenticated-orcid":false,"given":"\u00c7a\u011fatay","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Akdeniz University Medical Faculty, Antalya 07000, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0660-971X","authenticated-orcid":false,"given":"Mutay","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Akdeniz University Medical Faculty, Antalya 07000, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1038\/s12276-023-01018-9","article-title":"Functional roles of sphingolipids in immunity and their implication in disease","volume":"55","author":"Lee","year":"2023","journal-title":"Exp. 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