Department of Vascular Surgery, Medway Maritime Hospital, Windmill Rd, Gillingham, ME7 5NY, United Kingdom.
J Breath Res. 2018 May 14;12(3):036015. doi: 10.1088/1752-7163/aabd88.
Breath acetone concentrations were measured in 141 subjects (aged 19-91 years, mean = 59.11 years, standard deviation = 12.99 years), male and female, undergoing an oral glucose tolerance test (OGTT), having been referred to clinic on suspicion of type 2 diabetes. Breath samples were measured using an ion-molecule-reaction mass spectrometer, at the commencement of the OGTT, and after 1 and 2 h. Subjects were asked to observe the normal routine before and during the OGTT, which includes an overnight fast and ingestion of 75 g glucose at the beginning of the routine. Several groups of diagnosis were identified: type 2 diabetes mellitus positive (T2DM), n = 22; impaired glucose intolerance (IGT), n = 33; impaired fasting glucose, n = 14; and reactive hypoglycaemia, n = 5. The subjects with no diagnosis (i.e. normoglycaemia) were used as a control group, n = 67. Distributions of breath acetone are presented for the different groups. There was no evidence of a direct relationship between blood glucose (BG) and acetone measurements at any time during the study (0 h: p = 0.4482; 1 h: p = 0.6854; and 2 h: p = 0.1858). Nor were there significant differences between the measurements of breath acetone for the control group and the T2DM group (0 h: p = 0.1759; 1 h: p = 0.4521; and 2 h: p = 0.7343). However, the ratio of breath acetone at 1 h to the initial breath acetone was found to be significantly different for the T2DM group compared to both the control and IGT groups (p = 0.0189 and 0.011, respectively). The T2DM group was also found to be different in terms of ratio of breath acetone after 1 h to that at 2 h during the OGTT. And was distinctive in that it showed a significant dependence upon the level of BG at 2 h (p = 0.0146). We conclude that single measurements of the concentrations of breath acetone cannot be used as a potential screening diagnostic for T2DM diabetes in this cohort, but monitoring the evolution of breath acetone could open a non-invasive window to aid in the diagnosis of metabolic conditions.
在这项研究中，141 名受试者（年龄 19-91 岁，平均 59.11 岁，标准差 12.99 岁，男女性别各半）接受了口服葡萄糖耐量试验（OGTT），这些受试者均因疑似 2 型糖尿病而被转诊至诊所。在 OGTT 开始时以及 1 小时和 2 小时后，使用离子-分子反应质谱仪测量了受试者的呼气丙酮浓度。在 OGTT 前和 OGTT 期间，要求受试者按照常规禁食，并在开始时摄入 75g 葡萄糖。确定了几组诊断结果：2 型糖尿病阳性（T2DM），n=22；葡萄糖耐量受损（IGT），n=33；空腹血糖受损，n=14；反应性低血糖，n=5。无诊断（即血糖正常）的受试者被用作对照组，n=67。为不同组呈现了呼气丙酮的分布。在研究期间的任何时间，都没有发现血液葡萄糖（BG）和丙酮测量之间存在直接关系（0 小时：p=0.4482；1 小时：p=0.6854；2 小时：p=0.1858）。对照组和 T2DM 组的呼气丙酮测量值之间也没有显著差异（0 小时：p=0.1759；1 小时：p=0.4521；2 小时：p=0.7343）。然而，与对照组和 IGT 组相比，T2DM 组在 1 小时时呼气丙酮与初始呼气丙酮的比值明显不同（分别为 p=0.0189 和 0.011）。在 OGTT 期间，T2DM 组 1 小时后的呼气丙酮与 2 小时后的呼气丙酮比值也存在差异，并且与 2 小时时的 BG 水平显著相关（p=0.0146）。我们得出结论，在该队列中，不能将呼气丙酮浓度的单次测量用作 T2DM 糖尿病的潜在筛查诊断，但监测呼气丙酮的演变可能会打开一扇非侵入性窗口，以帮助诊断代谢状况。
