The 13C-glucose breath test is a valid non-invasive screening tool to identify metabolic syndrome in adolescents

Salas-Fernández, Alejandra; Maldonado-Hernández, Jorge; Martínez-Basila, Azucena; Gabriel, Marcin; Jasso-Saavedra, Filiberto

doi:10.1515/cclm-2014-0412

Cited by 13 publications

(13 citation statements)

References 9 publications

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“…Our results are similar to those described by Ibarra-Pastrana et al (22) in Mexican adults, where the 13 C-GBT rendered a sensitivity of 80% and a specificity of 67.4% when compared to HOMA-IR. Moreover, the cut-off points proposed in this article are comparable with the ones recommended for the detection of metabolic syndrome in adolescents (sensitivity=81.5% and specificity=66.7%) in a recent study published by our group (16). …”

Section: Discussionsupporting

confidence: 73%

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The 13C-Glucose Breath Test for Insulin Resistance Assessment in Adolescents: Comparison with Fasting and Post-Glucose Stimulus Surrogate Markers of Insulin Resistance

Maldonado-Hernández

Martínez-Basila²,

Salas-Fernández³

et al. 2016

Jcrpe

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Objective:To evaluate the use of the 13C-glucose breath test (13C-GBT) for insulin resistance (IR) detection in adolescents through comparison with fasting and post-glucose stimulus surrogates.Methods:One hundred thirty-three adolescents aged between 10 and 16 years received an oral glucose load of 1.75 g per kg of body weight dissolved in 150 mL of water followed by an oral dose of 1.5 mg/kg of U-13C-Glucose, without a specific maximum dose. Blood samples were drawn at baseline and 120 minutes, while breath samples were obtained at baseline and at 30, 60, 90, 120, 150, and 180 minutes. The 13C-GBT was compared to homeostasis model assessment (HOMA) IR (≥p95 adjusted by gender and age), fasting plasma insulin (≥p90 adjusted by gender and Tanner stage), results of 2-h oral glucose tolerance test (OGTT), insulin levels (≥65 μU/mL) in order to determine the optimal cut-off point for IR diagnosis.Results:13C-GBT data, expressed as adjusted cumulative percentage of oxidized dose (A% OD), correlated inversely with fasting and post-load IR surrogates. Sexual development alters A% OD results, therefore individuals were stratified into pubescent and post-pubescent. The optimal cut-off point for the 13C-GBT in pubescent individuals was 16.3% (sensitivity=82.8% & specificity=60.6%) and 13.0% in post-pubescents (sensitivity=87.5% & specificity=63.6%), when compared to fasting plasma insulin. Similar results were observed against HOMA and 2-h OGTT insulin.Conclusion:The 13C-GBT is a practical and non-invasive method to screen for IR in adolescents with reasonable sensitivity and specificity.

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Section: Discussionsupporting

confidence: 73%

“…Recently, our group demonstrated that the 13 C-GBT is a reproducible method to identify glucose metabolism defects also in adults without T2DM (14). We also established that the 13 C-GBT is a valid method for screening for metabolic syndrome in adolescents (16). …”

Section: Introductionmentioning

confidence: 90%

The 13C-Glucose Breath Test for Insulin Resistance Assessment in Adolescents: Comparison with Fasting and Post-Glucose Stimulus Surrogate Markers of Insulin Resistance

Maldonado-Hernández

Martínez-Basila²,

Salas-Fernández³

et al. 2016

Jcrpe

Self Cite

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“…Clinical data and biological samples of ninety-four adolescents from two previous studies conducted and published by our crew were selected by convenience [14, 15]. Only those subjects who had intact plasma for liver enzymes and ceramides determinations were included.…”

Section: Methodsmentioning

confidence: 99%

“…Both studies complied with the World Medical Association Declaration of Helsinki regarding ethical conduct of research in human subjects. Protocols were approved by the Ethics Committee of the Mexican Institute of Social Security with register numbers R-2010-3603-35 [14] and R-2010-3603-14 [15], respectively. Informed consent was obtained from the representative of all the study subjects.…”

Section: Methodsmentioning

confidence: 99%

Association between Plasmatic Ceramides Profile and AST/ALT Ratio: C14:0 Ceramide as Predictor of Hepatic Steatosis in Adolescents Independently of Obesity

Maldonado-Hernández

Saldaña-Dávila

Piña-Aguero

et al. 2017

Canadian Journal of Gastroenterology and Hepatology

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Objective To assess the association between plasma ceramides and hepatic steatosis (HS) in adolescents, independently of obesity. Materials and Methods Ninety-four adolescents from two previous studies conducted and published by our crew were included. Study subjects were stratified in three groups: normal weight (n = 18), obesity (n = 34), and obesity + HS (n = 42). The presence of HS was defined when ALT/AST ratio was <1. Ceramides subspecies (C14:0, C16:0, C18:0, C24:0, and C24:1) were determined by LC/MS. Results All ceramides correlated directly with ALT levels and inversely with ALT/AST ratio; the strongest correlation was observed among C14:0 ceramide (r = 0.41 and r = −0.54, resp.; P < 0.001). Furthermore, significant correlations were observed between cholesterol and all ceramides except for C24:1 ceramide. Interestingly ceramides C14:0, C18:0, and C24:1 correlated directly with both fasting insulin and HOMA-IR index. For assessing HS, a cut-off point of 10.3 nmol/L for C14:0 ceramide reported a sensitivity of 92.7% and a specificity of 73.5% when normal weight and obesity groups (n = 52) were compared against obesity + HS group (n = 42). Positive and negative predictive values were 77.5% and 90.2%, respectively. Conclusions Plasma ceramides are closely associated with hepatic steatosis in adolescents. C14:0 ceramide could be a novel biomarker of HS independently of obesity.

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“…However, the HOMA index is an invasive method that requires blood testing [4]. Recently, the 13 C-glucose breath test (C-GBT) has been proposed as a valid non-invasive screening tool to identify MS in adolescents [5]. This method is based on the assumption that subjects with impaired glucose metabolism or type II diabetes mellitus (T2DM) will have a lesser CO 2 amount in their breath owing to an impaired glucose uptake.…”

Section: Introductionmentioning

confidence: 99%

Association between Auricular Signals and the Risk Factors of Metabolic Syndrome

et al. 2017

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Objective: This study aims to determine the association between auricular signals and the risk factors of metabolic syndrome (MS). Methods: A case-control study with an equal number of cases and controls matched by age group and gender was conducted. A total of 204 participants were recruited. Patients were verified as having MS based on the International Diabetes Federation (IDF) criteria. Auricular assessment was conducted in the following sequence: visual inspection, electrical skin resistance test (ESRT), and pressure pain test (PPT). Results: MS+ patients tend to have much more oily auricle complexion than the controls. The ‘endocrine’ (right) of the participants with MS indicated a significantly higher electrical conductivity compared to that of the controls. The MS group participants experienced significant tenderness on the ‘heart’ and ‘endocrine’ acupoints. A number of auricular signals were also associated with the risk factors of MS, including age, gender, smoking status, family history of diabetes, and comorbid illnesses. Both the ‘heart’ and ‘endocrine’ acupoints showed the highest sensitivity to tenderness (60.8%), followed by the ‘endocrine’ (59.8%) and ‘pancreas and gallbladder’ (55.9%). Conclusions: The results of this study suggest that electrical conductivity and tenderness of a number of auricular points, including the ‘heart’, ‘pancreas and gall bladder’, and ‘endocrine’, are associated with MS and its risk factors. Further investigations with a larger sample size could be conducted to verify the value of these auricular signals on MS risk prediction so that this method can be used as an early screening method for the population with a high MS risk.

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The 13C-glucose breath test is a valid non-invasive screening tool to identify metabolic syndrome in adolescents

Abstract: Our results demonstrate that the 13C-glucose breath test could be a valid screening method to identify MS in adolescents.

Cited by 13 publications

References 9 publications

The 13C-Glucose Breath Test for Insulin Resistance Assessment in Adolescents: Comparison with Fasting and Post-Glucose Stimulus Surrogate Markers of Insulin Resistance

The 13C-Glucose Breath Test for Insulin Resistance Assessment in Adolescents: Comparison with Fasting and Post-Glucose Stimulus Surrogate Markers of Insulin Resistance

Association between Plasmatic Ceramides Profile and AST/ALT Ratio: C14:0 Ceramide as Predictor of Hepatic Steatosis in Adolescents Independently of Obesity

Association between Auricular Signals and the Risk Factors of Metabolic Syndrome

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