Breath acetone as a potential marker in clinical practice

Abstract

In recent decades, two facts have changed the opinion of researchers about the function of acetone in humans. Firstly, it has turned out that acetone cannot be regarded as simply a waste product of metabolism, because there are several pathways in which acetone is produced or broken down. Secondly, methods have emerged making possible its detection in exhaled breath, thereby offering an attractive alternative to investigation of blood and urine samples. From a clinical point of view the measurement of breath acetone levels is important, but there are limitations to its wide application. These limitations can be divided into two classes, technical and biological limits. The technical limits include the storage of samples, detection threshold, standardization of clinical settings, and the price of instruments. When considering the biological ranges of acetone, personal factors such as race, age, gender, weight, food consumption, medication, illicit drugs, and even profession/class have to be taken into account to use concentration information for disorders. In some diseases such as diabetes mellitus and lung cancer, as well as in nutrition-related behavior such as starvation and ketogenic diet, breath acetone has been extensively examined. At the same time, there is a lack of investigations in other cases in which ketosis is also evident, such as in alcoholism or an inborn error of metabolism. In summary, the detection of acetone in exhaled breath is a useful and promising tool for diagnosis and it can be used as a marker to follow the effectiveness of treatments in some disorders. However, further endeavors are needed for clarification of the exact distribution of acetone in different body compartments and evaluation of its complex role in humans, especially in those cases in which a ketotic state also occurs. RECEIVED

Metabolomic Status of The Oral Cavity in Chronic Periodontitis

“…in vivo 33: 1165-1174 (2019) Acetone originates from breakdown of acetoacetate and αhydroxybutyrate, accompanying fatty acid degradation, glycolysis, and pyruvate metabolism (55-57). Acetone mouth odor is mainly associated with diabetes and halitosis, however, its higher level in body fluids may be used in clinical diagnostics (56)(57)(58). The metabolism of acetone is closely associated with the production of lactic acid, which in this study was increased, therefore can be the product, at least in part of acetone biotransformation (57).…”

“…Increased level of isopropanol in samples from CPD-affected patients is rather surprising, considering that it is used as a common disinfectant and antiseptic agent. However, the positive correlation between isopropanol and acetone was found, where acetone can also be the product of isopropanol breakdown (56).…”

Laser spectroscopy for breath analysis: towards clinical implementation

“…Using a broadband tunable Tm/Ho-doped fiber laser (4780-5560 cm −1 ) and placing the sample inside the cavity, simultaneous detection of H 2 [119]. Furthermore, also broadband absorbing molecules, such as acetone [152], can be detected in breath samples with a portable and compact system. For example, Hancock et al have demonstrated lab-based mid-and near-IR CEAS systems for breath acetone detection [98,101].…”

Analysis of Nitrogen-containing Compounds in Mouth-exhaled Breath by Electrospray Ionization Quadrupole Time-of-Flight Mass Spectrometry

“…It can be conversed from acetoacetate and isopropanol in the human body. 30 The breath acetone is related to the blood glucose level, and may be used as an indicator for diabetes mellitus. 31,32 Indole and 2-furanmethanol have also been observed in the human breath in previous studies, 33,34 although their pathways are unclear.…”