Postmortem identification of hyperglycemia

Vitreous Humor: A Short Review on Post-mortem Applications

“…During ketoacidosis, BHB is found in the highest concentrations and seems to be the most specific post-mortem marker of ketoacidosis [5,8,[67][68][69]. Therefore, BHB has been well studied in VH [6,8,69].…”

“…An increase in the rate of glycolysis has been found in VH during the early post-mortem period, leading to a decrease in glucose concentrations [5,14,66,73]. Thus, low vitreous glucose concentration is not synonymous with hypoglycemia [73].…”

“…It is composed of a complex network of cross-linked collagen fibers and hydrophilic glycosaminoglycan hyaluronan [4], which constitutes a hydrated gel containing few cells [5,6]. It contains 99% water and solids in the form of macromolecular and low molecular weight constituents, such as sugars, urea, creatinine, and electrolytes.…”

“…VH is preferred for post-mortem investigations because of its large volume [9] and easy accessibility [5,9,10]. VH can be obtained even in cases in which blood and urine specimens are not accessible [11,12].…”

“…VH is relatively inert and only slightly influenced by sudden fluctuations in the blood chemistry [9]. The isolate nature of VH, compared to blood and Cerebrospinal Fluid (CSF), and its resistance to microbiological contamination with bacterial degradation [5,6,11,[13][14][15][16][17][18][19][20][21] makes VH a very suitable medium for post-mortem biochemical investigation [13][14][15][16][17]. Moreover, its composition is more stable and less affected by post-mortem changes than CSF [14,21,22] or blood [5,6,10,14,21,22].…”