Factors influencing breath analysis results in patients with diabetes mellitus

Abstract

Breath analysis is used to detect the composition of exhaled gas. As a quick and non-invasive detection method, breath analysis provides deep insights into the progression of various kinds of diseases, especially those with metabolism disorders. Abundant information on volatile compounds in diabetic patients has been studied in numerous articles in the literature. However, exhaled gas in diabetic patients can be altered by various complications. So far, little attention has been paid to this alteration. In our paper, we found that under air pollution conditions, diabetic patients exhale more nitric oxide. Diabetic patients with heart failure exhale more acetone than those without heart failure. After 13 C-labeled glucose intake, patients infected with Helicobacter pylori exhaled more 13 C and less 18 O than those without infection. Exhalation with chronic kidney disease changes volatile organic compounds on a large scale. Diabetic patients with ketoacidosis exhale more acetone than those without ketoacidosis. Some specific volatile organic compounds also emanate from diabetic feet. By monitoring breath frequency, diabetic patients with obstructive sleep apnea syndrome exhibit a unique breath pattern and rhythm as compared with other diabetic patients, and sleep apnea is prevalent among diabetic patients. In addition to clinical findings, we analyzed the underlying mechanisms at the levels of molecules, cells and whole bodies, and provided suggestions for further studies. List of abbreviations HpHelicobacter pylori T2DMType 2 diabetes mellitus HbA1c Glycosylated hemoglobin A1c FeNO Fraction of exhaled nitric oxide PM Particulate matter NO 2 Nitrogen dioxide SO 2 Sulfur dioxide NOx Nitrogen oxide CO 2 Carbon dioxide GC-MS Gas chromatography-mass spectrometry DM Diabetes mellitus VOCs Volatile organic compounds CKD Chronic kidney disease COPD Chronic obstructive pulmonary disease RECEIVED

The correlation between breath acetone and blood betahydroxybutyrate in individuals with type 1 diabetes

“…It has long been known that elevated levels of breath acetone can occur in individuals with untreated type 1 diabetes [1], and there has been much effort devoted to studies attempting to show the usefulness of acetone breath testing in the management or diagnosis of the disease [2][3][4][5]. Acetone is formed by the decarboxylation of a ketoacid, acetoacetic acid, which is virtually 100% dissociated in the blood to form the acetoacetate anion (AcAc).…”

Exhaled Breath Analysis for Diabetes Diagnosis and Monitoring: Relevance, Challenges and Possibilities

“…The presence of comorbidities complicates the exhaled breath analysis further. Diabetes is often accompanied by other health conditions, such as kidney diseases, diabetic ketoacidosis, diabetic foot, obstructive sleep apnea syndrome, halitosis, and Helicobacter pylori infection [ 57 ]. Not only do numerous diseases co-exist, but they may also have similar breath biomarkers.…”

Breathome discriminate Ischemic Heart Disease

“…Exhaled air analysis has been performed in patients with different pathologies including chronic obstructive lung disease, cancer, asthma, lung cancer, diabetes, arthritis, heart failure, gastric cancer, chronic kidney disease, colorectal cancer, hepatocellular carcinoma, malignant pleural mesothelioma, bladder cancer, pancreatic ductal adenocarcinoma, gastro-oesophageal cancer, peritonitis-shock, head and neck squamous cell carcinoma, multiple sclerosis, and Parkinson's disease [8,9,[18][19][20][21][22][23][24][25][26][27]10,[28][29][30][31][32][33][34][35][36][37]11,[38][39][40][41][42][43][44][45][46][47][12][13][14][15][16][17].…”