Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals
Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals
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DOI：
10.1093/ajcn/76.1.65
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发表时间：
2002-07-01
影响因子：
7.1
通讯作者：
Cunnane, SC
中科院分区：
文献类型：
--
作者：
Musa-Veloso, K;Likhodii, SS;Cunnane, SC
背景：生酮饮食用于治疗顽固性癫痫发作。临床上，酮症的维持对于饮食改善癫痫发作的功效至关重要。为了了解酮症和癫痫保护之间的关系，需要一种可靠、无创的酮症测量方法，可以经常进行且不适感最小。 目的：目的是确定哪一个指标（呼吸丙酮或尿乙酰乙酸）与血浆酮乙酰乙酸和 β-羟基丁酸的相关性更强。 设计：禁食过夜 12 小时后，12 名健康者 成年人在 12 小时内吃了 4 顿生酮餐。每小时收集血液、呼吸和尿液样本。分析血液中的血浆乙酰乙酸盐和 β-羟基丁酸盐、呼气中的丙酮以及尿液中的乙酰乙酸盐。结果：在 12 小时饮食治疗结束时，血浆乙酰乙酸盐、血浆 β-羟基丁酸盐和呼气丙酮增加了 3.5 倍，而尿液中的乙酰乙酸增加了 13 倍。 当用尿酮试纸测量时，酶促反应是 25 倍。血浆乙酰乙酸盐最好通过呼吸丙酮来预测（R-2 = 0.70，P < 0.0001）。呼气丙酮和尿乙酰乙酸对血浆 β-羟基丁酸的预测效果相同（R-2 = 0.54，P = 0.0040）。结论：呼气丙酮与尿乙酰乙酸一样，是酮症的良好预测因子。呼气丙酮分析是无创的，可以频繁进行，对患者的不适最小化。作为生酮饮食的癫痫患者的酮症指标，呼气丙酮可能有助于了解饮食的机制，阐明酮症在癫痫发作保护中的重要性，并最终通过改善患者监测来提高饮食的功效。
Background: Ketogenic diets are used therapeutically to treat intractable seizures. Clinically, it appears that the maintenance of ketosis is crucial to the efficacy of the diet in ameliorating seizures. To understand how ketosis and seizure protection are related, a reliable, noninvasive measure of ketosis that can be performed frequently with minimal discomfort is needed,Objective: The objective was to determine which index, breath acetone or urinary acetoacetate, is more strongly related to the plasma ketones acetoacetate and beta-hydroxybutyrate.Design: After fasting overnight for 12 h, 12 healthy adults consumed 4 ketogenic meals over 12 h. Blood, breath, and urine samples were collected hourly. Blood was analyzed for plasma acetoacetate and beta-hydroxybutyrate, breath for acetone, and urine for acetoacetate.Results: By the end of the 12-h dietary treatment, plasma acetoacetate, plasma beta-hydroxybutyrate, and breath acetone had increased 3.5-fold, whereas urinary acetoacetate increased 13-fold when measured enzymatically and 25-fold when measured with urinary ketone dipsticks. Plasma acetoacetate was best predicted by breath acetone (R-2 = 0.70, P < 0.0001). Plasma beta-hydroxybutyrate was equally predicted by breath acetone and urinary acetoacetate (R-2 = 0,54, P = 0.0040).Conclusions: Breath acetone is as good a predictor of ketosis as is urinary acetoacetate. Breath acetone analysis is noninvasive and can be performed frequently with minimal discomfort to patients. As an indicator of ketosis in epilepsy patients consuming a ketogenic diet, breath acetone may be useful for understanding the mechanism of the diet, elucidating the importance of ketosis in seizure protection, and ultimately, enhancing the efficacy of the diet by improving patient monitoring.