Blood ketone bodies and breath acetone analysis and their correlations in type 2 diabetes mellitus

Analysis of volatile organic compounds in the breath for disease detection and monitoring has gained momentum and clinical significance due to its rapid test results and non-invasiveness, especially for diabetes mellitus (DM). Studies have suggested that breath gases, including acetone, may be related to simultaneous blood glucose (BG) and blood ketone levels in adults with types 2 and 1 diabetes. Detecting altered concentrations of ketones in the breath, blood and urine may be crucial for the diagnosis and monitoring of diabetes mellitus. This study assesses the e cacy of a simple breath test as a non-invasive means of diabetes monitoring in adults with type 2 diabetes mellitus. Human breath samples were collected in Tedlar bags and analyzed by headspace solid-phase microextraction and gas chromatography-mass spectrometry (HS-SPME/GC-MS). The measurements were compared with capillary BG and blood ketone levels ( -hydroxybutyrate and acetoacetate) taken at the same time on a single visit to a routine hospital clinic in 30 subjects with type 2 diabetes and 28 control volunteers. Ketone bodies of diabetic subjects showed a significant increase when compared to the control subjects; however, the ketone levels were was controlled in both diabetic and non-diabetic volunteers. Worthy of note, a statistically significant relationship was found between breath acetone and blood acetoacetate (R = 0.89) and between breath acetone and -hydroxybutyrate (R = 0.82).Figure S1: Reconstructed GC-MS ion chromatograms (m/z 181) of patient breath samples without insulin injection (a), diabetic breath with insulin (b), and non-diabetic breath (c) sampled using on-fiber SPME derivatization with PFBHA. Figure S2: The measured breath acetone concentration by SPME GC/MS and versus blood glucose in diabetic patients.DSI-CSIRhttps://www.mdpi.com/journal/diagnosticsam2020BiochemistryGeneticsMicrobiology and Plant Patholog