To determine if ketoacidosis contributes to reduced apolipoprotein A1 (apoA1) expression in insulindeficient diabetic rats, we examined the regulation of apoA1 gene expression in response to changes in ambient pH or ketone body concentrations. Hepatic apoAI mRNA levels were reduced 42% in diabetic rats relative to nondiabetic controls (means ..; 321·8 43·7 vs 438·7 58·8 arbitrary units; P<0·03). Neither endogenous apoA1 mRNA nor transcriptional activity of the rat apoA1 gene promoter (from 474 to 7) were altered by sodium butyrate or isobutyramide (0·3 mM to 10 mM) in Hep G2 or Caco-2 cells. Rat hepatic and intestinal apoA1 mRNA levels, and plasma apoA1 concentration, were not altered 24 h after isobutyramide administration (500 mg/kg by gavage). When the effect of altering ambient pH within a wide range commonly encountered in vivo was studied, acidosis (pH 6·7), relative to alkalosis (pH 7·9), decreased apoAI mRNA levels relative to glyceraldehyde-3-phosphate dehydrogenase mRNA by 47% in Hep G2 cells (P<0·025) and by 24% in Caco-2 cells (P<0·017). Acidosis did not alter cytomegalo virus (CMV)--galactosidase activity, or the activity of the simian virus (SV40) early-region promoter, in either cell line transfected with the respective constructs. The lowering of ambient pH was associated with a graded reduction in apoAI promoter activity. At pH 6·7, apoAI promoter activity was reduced by 75% compared with promoter activity at pH 7·9. These observations indicate that acidosis, but not ketosis, contributes to the reduction in apoA1 expression during diabetic ketoacidosis by down-regulating apoAI promoter activity.