Exhaled volatile substances in children suffering from type 1 diabetes mellitus: results from a cross-sectional study
Exhaled volatile substances in children suffering from type 1 diabetes mellitus: results from a cross-sectional study
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DOI：
10.1038/s41598-019-52165-x
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发表时间：
2019-10-31
影响因子：
4.6
通讯作者：
Fischer, Dagmar-Christiane
中科院分区：
文献类型：
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作者：
Trefz, Phillip;Obermeier, Juliane;Fischer, Dagmar-Christiane
监测儿童对1型糖尿病的代谢适应具有挑战性。呼气中挥发性有机化合物（VOCs）的分析是非侵入性的，是一种很有前途的工具。然而，关于儿科患者呼吸VOC谱的数据是有限的。我们对1型糖尿病（T1DM）患儿（53例）和健康对照（60例）的呼出VOCs进行了横断面研究和定量分析。两组人的性别和年龄都是匹配的。对于呼吸气体的分析，采用了一种非常灵敏的直接质谱技术（PTR-TOF）。病程、胰岛素使用方式（连续皮下注射胰岛素vs每日多次注射胰岛素）和长期代谢控制被视为患者的分类指标。T1DM患者与健康儿童呼出VOCs浓度存在差异。特别是，与健康对照组相比，T1DM患者呼出的乙醇、异丙醇、二甲硫醚、异戊二烯和戊醛的含量明显更高（171、1223、19.6、112和13.5 ppbV vs. 82.4、784、11.3、49.6和5.30 ppbV）。在代谢控制较差的患者（即平均HbA（1c）高于8%的患者）中发现了最显著的浓度差异。总之，无创呼吸测试可能有助于发现T1DM进展早期的基本代谢机制和适应。
Monitoring metabolic adaptation to type 1 diabetes mellitus in children is challenging. Analysis of volatile organic compounds (VOCs) in exhaled breath is non-invasive and appears as a promising tool. However, data on breath VOC profiles in pediatric patients are limited. We conducted a cross-sectional study and applied quantitative analysis of exhaled VOCs in children suffering from type 1 diabetes mellitus (T1DM) (n = 53) and healthy controls (n = 60). Both groups were matched for sex and age. For breath gas analysis, a very sensitive direct mass spectrometric technique (PTR-TOF) was applied. The duration of disease, the mode of insulin application (continuous subcutaneous insulin infusion vs. multiple daily insulin injection) and long-term metabolic control were considered as classifiers in patients. The concentration of exhaled VOCs differed between T1DM patients and healthy children. In particular, T1DM patients exhaled significantly higher amounts of ethanol, isopropanol, dimethylsulfid, isoprene and pentanal compared to healthy controls (171, 1223, 19.6, 112 and 13.5 ppbV vs. 82.4, 784, 11.3, 49.6, and 5.30 ppbV). The most remarkable differences in concentrations were found in patients with poor metabolic control, i.e. those with a mean HbA(1c) above 8%. In conclusion, non-invasive breath testing may support the discovery of basic metabolic mechanisms and adaptation early in the progress of T1DM.