Methodological characterization of the 2-keto [1-13C]isocaproate breath test to measure in vivo human mitochondrial function: application in alcoholic liver disease assessment.

BACKGROUND

The 2-keto[1-13C]isocaproate oxidation measurement has been shown as a helpful tool in the in vivo assessment of liver mitochondrial function.

METHODS

The aim of this work was to study the variability of the 2-keto[1-13C]isocaproate breath test in 24 healthy controls (8 men and 16 women) and to evaluate its clinical usefulness in 20 patients (14 men and 6 women) with liver disease (7 men with history of alcoholism). Breath test was performed by measuring 13CO2 enrichment in breath before and after the oral administration of the tracer and by using isotope ratio mass spectrometry.

RESULTS

The intrasubject and intersubject variability of the percentage of tracer oxidized were 8 and 14%, respectively. The 2-keto[1-13C]isocaproate oxidation in women was faster (p = 0.004) and tended to be higher (p = 0.050) than in men. The percentage of oxidized tracer was lower in those patients with alcoholic liver disease than in healthy volunteers (p = 0.001) and in nonalcoholic patients (p = 0.003).

CONCLUSIONS

The percentage of tracer oxidized appears as a convenient parameter to detect impairment in liver mitochondrial oxidation related to alcoholism by the 2-keto[1-13C]isocaproate breath test, establishing different cutoff values depending on gender.