Breath Ketone Testing: A New Biomarker for Diagnosis and Therapeutic Monitoring of Diabetic Ketosis

Qiao, Yue; Gao, Zhiqiang; Liu, Yong; Cheng, Yan; Yu, Mengxiao; Zhao, Lingling; Duan, Yixiang; Liu, Yu

doi:10.1155/2014/869186

Cited by 54 publications

(46 citation statements)

References 8 publications

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“…Multiple studies have reported strong correlations between BrAce and BOHB with an average R 2 = 0.77 [Range: 0.54 to 0.94] . To demonstrate this relationship, blood‐breath data from multiple studies were captured and plotted (Figure ) . The data was fit with an exponential relationship .…”

Section: Breath Acetone and Bohbmentioning

confidence: 99%

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Measuring breath acetone for monitoring fat loss: Review

Anderson

2015

Obesity

173

140

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ObjectiveEndogenous acetone production is a by‐product of the fat metabolism process. Because of its small size, acetone appears in exhaled breath. Historically, endogenous acetone has been measured in exhaled breath to monitor ketosis in healthy and diabetic subjects. Recently, breath acetone concentration (BrAce) has been shown to correlate with the rate of fat loss in healthy individuals. In this review, the measurement of breath acetone in healthy subjects is evaluated for its utility in predicting fat loss and its sensitivity to changes in physiologic parameters.ResultsBrAce can range from 1 ppm in healthy non‐dieting subjects to 1,250 ppm in diabetic ketoacidosis. A strong correlation exists between increased BrAce and the rate of fat loss. Multiple metabolic and respiratory factors affect the measurement of BrAce. BrAce is most affected by changes in the following factors (in descending order): dietary macronutrient composition, caloric restriction, exercise, pulmonary factors, and other assorted factors that increase fat metabolism or inhibit acetone metabolism. Pulmonary factors affecting acetone exchange in the lung should be controlled to optimize the breath sample for measurement.ConclusionsWhen biologic factors are controlled, BrAce measurement provides a non‐invasive tool for monitoring the rate of fat loss in healthy subjects.

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Section: Breath Acetone and Bohbmentioning

confidence: 99%

“… Breath acetone concentration (BrAce) has a non‐linear relationship with blood β‐hydroxybutyrate. Experimental data (open circles) were captured from multiple studies and fit (black line) using an exponential relationship . 1 ppm = 39.7 nM (molar basis).…”

Section: Breath Acetone and Bohbmentioning

confidence: 99%

Measuring breath acetone for monitoring fat loss: Review

Anderson

2015

Obesity

173

140

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“…28 An association between an increased level of HbA1c with the presence of halitosis has been described. 12 Some authors have suggested breath acetone as a biomarker of poor metabolic control in children with diabetes, 11,12 since ketonic bodies are increased in uncontrolled patients. Our study corroborates the literature, as breath acetone and xerostomia were significantly increased in the uncontrolled children.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,4 Regarding the oral manifestation of type 1 diabetes, the association between periodontal disease and diabetes is already well established in adults, [5][6][7][8][9] as well as the incidence of xerostomia 10 and breath acetone. 11,12 Diabetes-related parameters have been linked to periodontal problems in children 5,6,13 and also accelerated tooth eruption. 14 On the other hand, it is still controversial whether these parameters are associated with dental caries [15][16][17][18][19] and oral manifestations, such as geographic and coated tongue.…”

Section: Palavrasmentioning

confidence: 99%

Oral Health and Dental Care Related to Diabetes Status in Young Children

Oliveira¹,

Martins²,

Freitas-Fernandes³

et al. 2018

CRORJ

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This study compares the oral health, dietary and oral hygiene habits and dental care experience of children with type 1 diabetes (DG) to healthy ones (HG) under six years old. Methods: The children were chosen matched by gender and age in each group. Diabetes status from DG was determined using HbA1c criteria levels: <8.5% (69 mmol/mol) was considered controlled and >8.5% uncontrolled. Guardians were asked about oral hygiene, dietary habits and dental care experience. Oral examination was performed in order to assess dental caries (dmft), plaque and calculus indexes, as well as oral manifestations in soft tissues. Data were described and analyzed by SPSS 20.0 software through Chi-square and T-tests. Results: A total of 68 children were enrolled in this study. Children with diabetes differed from healthy ones in relation to geographic tongue, breath acetone and xerostomia (p<0.05). Only 23% (n=7) of DG were considered as presenting uncontrolled diabetes status. Statistical differences between controlled and uncontrolled diabetic status were observed among children, such as age at diagnosis, disease duration, sugar consumption, dental visits, type of experience during dental appointment, presence of geographic tongue, dental caries, reported breath acetone and xerostomia (p<0.05). Toothache was the main reason that DG children had been to a dentist before. Conclusion: Oral health and dietary habits of children with diabetes differed from healthy ones. Most children with diabetes had never been to a dentist before. Oral manifestation and oral habits diverged from children uncontrolled and controlled diabetes.

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“…␤-Hydroxybutyrate is the most abundant circulating ketone body (78%) (30) and is usually used to directly reflect blood levels of ketone bodies (31). We next tested the serum levels of ␤-hydroxybutyrate under ad libitum feeding, fasting, and KDfed HKO mice and the Loxp control mice.…”

Section: Hepatocyte-specific Sirt6 Deficiency Impairs Ketogenesismentioning

confidence: 99%

Hepatocyte-specific Sirt6 deficiency impairs ketogenesis

Chen

Liu

Tang

et al. 2019

Journal of Biological Chemistry

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Sirt6 is an NADH (NAD ؉ )-dependent deacetylase with a critical role in hepatic lipid metabolism. Ketogenesis is controlled by a signaling network of hepatic lipid metabolism. However, how Sirt6 functions in ketogenesis remains unclear. Here, we demonstrated that Sirt6 functions as a mediator of ketogenesis in response to a fasting and ketogenic diet (KD). The KD-fed hepatocyte-specific Sirt6 deficiency (HKO) mice exhibited impaired ketogenesis, which was due to enhanced Fsp27 (fatspecific induction of protein 27), a protein known to regulate lipid metabolism. In contrast, overexpression of Sirt6 in mouse primary hepatocytes promoted ketogenesis. Mechanistically, Sirt6 repressed Fsp27␤ expression by interacting with Crebh (cAMP response element-binding protein H) and preventing its recruitment to the Fsp27␤ gene promoter. The KD-fed HKO mice also showed exacerbated hepatic steatosis and inflammation. Finally, Fsp27 silencing rescued hypoketonemia and other metabolic phenotypes in KD-fed HKO mice. Our data suggest that the Sirt6 -Crebh-Fsp27 axis is pivotal for hepatic lipid metabolism and inflammation. Sirt6 may be a pharmacological target to remedy metabolic diseases. De novo lipogenesis analysis using stable isotopes tracerNewly isolated mouse primary hepatocytes were seeded in 10-cm culture dishes and cultured in low-glucose Dulbecco's Sirt6 regulates ketogenesis

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Breath Ketone Testing: A New Biomarker for Diagnosis and Therapeutic Monitoring of Diabetic Ketosis

Cited by 54 publications

References 8 publications

Measuring breath acetone for monitoring fat loss: Review

Measuring breath acetone for monitoring fat loss: Review

Oral Health and Dental Care Related to Diabetes Status in Young Children

Hepatocyte-specific Sirt6 deficiency impairs ketogenesis

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