Exhaled breath analysis is a promising noninvasive method to detect fatty liver in children. Isoprene, acetone, trimethylamine, acetaldehyde, and pentane are novel biomarkers that may help to gain insight into pathophysiological processes leading to the development of NAFLD.

Background Breath testing is becoming an important diagnostic method to evaluate many disease states. In light of rising healthcare costs, is important to develop a simple non-invasive tool to potentially identify pediatric patients who need endoscopy for suspected inflammatory bowel disease (IBD). Aim The primary aim of this study was to analyze exhaled volatile organic compounds (VOCs) to evaluate for the presence of a unique breath pattern to differentiate pediatric patients with (IBD) from healthy controls. Methods A cross-sectional, single-center study included pediatric IBD patients and healthy controls (age range, 5-21 years). The diagnosis of IBD was confirmed by endoscopic, histologic, and radiographic data. Exhaled breath was collected and analyzed using a selective ion flow tube mass spectroscopy (SIFT-MS) to identify new markers or patterns of IBD. Results 117 patients (62 with IBD and 55 healthy controls) were included in the study. Linear discriminant analysis and principle component analysis of mass scanning ion peak data demonstrated 21 pre-selected VOCs correctly classify patients with IBD or as healthy controls; p < 0.0001. Multivariable logistic regression analysis further showed 3 specific VOCs (1-octene, 1-decene, (E)-2-nonene) had excellent accuracy for predicting the presence of IBD with an area under the curve (AUC) of 0.96 (95% CI: 0.93, 0.99). No significant difference in VOCs was found between patients with Crohn's disease or ulcerative colitis and no significant correlation was seen with disease activity. Conclusion This pilot data supports the hypothesis that a unique breathprint potentially exists for pediatric IBD in the exhaled metabolome.

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