Jonderko Krzysztof, Kamińska Magdalena, Kasicka-Jonderko Anna, Bożek Małgorzata, Radosz Magdalena, Szostak Karolina, Błońska-Fajfrowska Barbara
Department of Basic Biomedical Science, School of Pharmacy, Medical University of Silesia, Sosnowiec, Poland.
Isotopes Environ Health Stud. 2013 Jun;49(2):219-31. doi: 10.1080/10256016.2013.750244. Epub 2013 Mar 6.
The aim of this study was to check on the reproducibility of two breath tests intended to test the pancreatic exocrine function accomplished with (13)C-mixed triglyceride ((13)C-MTG) or cornflakes naturally enriched in (13)C ((13)C-CF). The (13)CO₂ content within breath samples was determined with isotope-selective non-dispersive infrared spectrometry. A 72-h monitoring performed in healthy subjects revealed that a statistically significant rise in breath (13)CO₂ occurs between the 1st and the 9th hour and between the 1st and the 24th hour after intake of a test meal containing 300 mg (13)C-MTG (n=10) or 100 g (13)C-CF (n=12), respectively. In another two groups of 12 healthy volunteers each, short-term reproducibility of the two tests was assessed with paired examinations taken at a median interval of two days, whereas paired examinations separated by a median of 20 days served for the medium-term reproducibility assessment. In the case of either test, the medium-term reproducibility was not any worse than the short-term one. The reproducibility of the (13)C-CF breath test tended to be slightly worse than that of the (13)C-MTG breath test: a least detectable difference in 6-h cumulative (13)C breath excretion (which is expressed as the percentage of the administered dose of the substrate) amounted to 2.7 and 4.4 % (short-term reproducibility) and to 3.5 and 4.4 % (medium-term reproducibility) in the case of the (13)C-MTG breath test and the (13)C-CF breath test, respectively. It is concluded that both tests offer a satisfactory reproducibility for use within a clinical setting. In case the lipolytic and the amylolytic activity would be required to be examined in the same patient, the (13)C-CF breath test can be executed on the next day following the (13)C-MTG breath test, whereas reciprocally, a 1-day break is recommended before accomplishment of a (13)C-MTG breath test following a (13)C-CF breath test.
本研究的目的是检验两种用于检测胰腺外分泌功能的呼气试验的可重复性，这两种试验分别采用（13）C混合甘油三酯（（13）C-MTG）或天然富含（13）C的玉米片（（13）C-CF）来完成。呼气样本中的（13）CO₂含量通过同位素选择性非分散红外光谱法测定。在健康受试者中进行的72小时监测显示，在摄入含有300毫克（13）C-MTG（n = 10）或100克（13）C-CF（n = 12）的试验餐后，呼气（13）CO₂在第1小时至第9小时之间以及第1小时至第24小时之间出现了具有统计学意义的升高。在另外两组每组12名健康志愿者中，通过以两天为中位数间隔进行的配对检查评估了这两种试验的短期可重复性，而以20天为中位数间隔分开的配对检查则用于中期可重复性评估。对于任何一种试验，中期可重复性并不比短期可重复性差。（13）C-CF呼气试验的可重复性往往略低于（13）C-MTG呼气试验：在（13）C-MTG呼气试验和（13）C-CF呼气试验中，6小时累积（13）C呼气排泄的最小可检测差异（以底物给药剂量的百分比表示）分别为2.7%和4.4%（短期可重复性）以及3.5%和4.4%（中期可重复性）。结论是，这两种试验在临床环境中使用时都具有令人满意的可重复性。如果需要在同一患者中检查脂肪分解和淀粉分解活性，则可以在（13）C-MTG呼气试验后的第二天进行（13）C-CF呼气试验，反之，在（13）C-CF呼气试验之后进行（13）C-MTG呼气试验之前建议间隔1天。
