Breath Acetone Correlates With Capillary β-hydroxybutyrate in Type 1 Diabetes.

IF 4.9 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Science and Technology Pub Date : 2026-09-01 Epub Date: 2025-04-22 DOI:10.1177/19322968251334640

Kai E Jones, Max C Petersen, Alexander M Markov, Maamoun Salam, Petra Krutilova, Alexis M McKee, Kathryn L Bohnert, Samantha E Adamson, Janet B McGill

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引用次数: 0

Abstract

Background: Breath acetone (BrACE) is an end product of ketone metabolism that is measurable by noninvasive breath ketone analyzers. We assessed the correlation between capillary blood β-hydroxybutyrate (BOHB) and BrACE in people with type 1 diabetes during 14 days of outpatient care with and without dapagliflozin treatment and during supervised insulin withdrawal studies with and without dapagliflozin.

Methods: In this randomized crossover study, participants completed two 14-day outpatient periods with or without dapagliflozin 10 mg daily. Each 14-day unsupervised outpatient period was followed by a 1-day supervised insulin withdrawal study. Paired BOHB and BrACE measurements were obtained 3 times daily during outpatient periods, then hourly during supervised insulin withdrawal. The correlation between BrACE and BOHB was assessed by Spearman's ρ.

Results: Twenty people with type 1 diabetes completed the study. During outpatient periods, BrACE and BOHB were moderately correlated (n = 1425 paired readings; ρ = .41; 95% CI = 0.36 to 0.45; P < .0001). However, BrACE and BOHB were strongly correlated during insulin withdrawal (n = 246 paired values, ρ = .81; 95% CI = 0.77 to 0.85). In ROC analysis, BrACE > 5 ppm demonstrated optimal sensitivity (93%) and specificity (87%) for detecting capillary BOHB ≥ 1.5 mmol/L. No serious adverse events occurred.

Conclusions: In adults with type 1 diabetes, measurement of breath acetone provides a noninvasive estimate of blood BOHB concentration. The correlation between BrACE and BOHB was suboptimal during unsupervised outpatient care, but was strong during supervised insulin withdrawal.

Trial registration: clinicaltrials.gov (NCT05541484).

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1型糖尿病患者呼吸丙酮与毛细血管β-羟基丁酸相关

背景：呼吸丙酮（BrACE）是酮代谢的最终产物，可通过无创呼吸酮分析仪测量。我们评估了1型糖尿病患者在接受和不接受达格列净治疗的14天门诊护理期间，以及在接受和不接受达格列净治疗的胰岛素戒断研究期间，毛细血管血β-羟基丁酸（BOHB）和BrACE之间的相关性。方法：在这项随机交叉研究中，参与者完成了两个14天的门诊期，每天服用或不服用达格列净10mg。每个14天的无监督门诊期之后是1天的有监督的胰岛素戒断研究。配对BOHB和BrACE测量在门诊期间每天获得3次，然后在监督胰岛素停药期间每小时获得一次。用Spearman ρ评价BrACE与BOHB的相关性。结果：20名1型糖尿病患者完成了这项研究。在门诊期间，BrACE和BOHB呈中度相关(n = 1425成对读数；ρ = .41；95% CI = 0.36 ~ 0.45；P < 0.0001)。然而，在胰岛素戒断期间，BrACE和BOHB密切相关(n = 246对值，ρ = 0.81；95% CI = 0.77 ~ 0.85)。在ROC分析中，BrACE > 5 ppm对检测毛细管BOHB≥1.5 mmol/L的灵敏度（93%）和特异性（87%）最佳。未发生严重不良事件。结论：在成人1型糖尿病患者中，呼吸丙酮的测量提供了血液BOHB浓度的无创估计。在无监督的门诊治疗期间，BrACE和BOHB的相关性不理想，但在有监督的胰岛素停药期间相关性较强。试验注册：clinicaltrials.gov （NCT05541484）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.