title: Determination of breath acetone in 149 type 2 diabetic patients using a ringdown breath-acetone analyzer.
abstract: Over 90% of diabetic patients have Type 2 diabetes. Although an elevated mean breath acetone concentration has been found to exist in Type 1 diabetes (T1D), information on breath acetone in Type 2 diabetes (T2D) has yet to be obtained. In this study, we first used gas chromatography-mass spectrometry (GC-MS) to validate a ringdown breath-acetone analyzer based on the cavity-ringdown-spectroscopy technique, through comparing breath acetone concentrations in the range 0.5-2.5 ppm measured using both methods. The linear fitting of R = 0.99 suggests that the acetone concentrations obtained using both methods are consistent with a largest standard deviation of ±0.4 ppm in the lowest concentration of the range. Next, 620 breath samples from 149 T2D patients and 42 healthy subjects were collected and tested using the breath analyzer. Four breath samples were taken from each subject under each of four different conditions: fasting, 2 h post-breakfast, 2 h post-lunch, and 2 h post-dinner. Simultaneous blood glucose levels were also measured using a standard diabetic-management blood-glucose meter. For the 149 T2D subjects, their exhaled breath acetone concentrations ranged from 0.1 to 19.8 ppm; four different ranges of breath acetone concentration, 0.1-19.8, 0.1-7.1, 0.1-6.3, and 0.1-9.5 ppm, were obtained for the subjects under the four different conditions, respectively. For the 42 healthy subjects, their breath acetone concentration ranged from 0.1 to 2.6 ppm; four different ranges of breath acetone concentration, 0.3-2.6, 0.1-2.6, 0.1-1.7, and 0.3-1.6 ppm, were obtained for the four different conditions. The mean breath acetone concentration of the 149 T2D subjects was determined to be 1.5 ± 1.5 ppm, which was 1.5 times that of 1.0 ± 0.6 ppm for the 42 healthy subjects. No correlation was found between the breath acetone concentration and the blood glucose level of the T2D subjects and the healthy volunteers. This study using a relatively large number of subjects provides new data regarding breath acetone in diabetes (T1D and T2D) and suggests that an elevated mean breath acetone concentration also exists in T2D.
authors.affiliation: Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300192, China.
authors.forename: Meixiu
authors.initials: M
authors.lastname: Sun
authors.forename: Zhuying
authors.initials: Z
authors.lastname: Chen
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Gong
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Zhao
authors.forename: Chenyu
authors.initials: C
authors.lastname: Jiang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yuan
authors.forename: Zhennang
authors.initials: Z
authors.lastname: Wang
authors.forename: Yingxin
authors.initials: Y
authors.lastname: Li
authors.forename: Chuji
authors.initials: C
authors.lastname: Wang
mesh_terms: D000096:Acetone / Q000378:metabolism*; D001944:Breath Tests / Q000295:instrumentation*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D057230:Limit of Detection
chemical_list: D000096:Acetone