Non-Invasive Assessment of Metabolic Adaptation in Paediatric Patients Suffering from Type 1 Diabetes Mellitus
Non-Invasive Assessment of Metabolic Adaptation in Paediatric Patients Suffering from Type 1 Diabetes Mellitus
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DOI：
10.3390/jcm8111797
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发表时间：
2019-11-01
影响因子：
3.9
通讯作者：
Fischer, Dagmar-Christiane
中科院分区：
文献类型：
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作者：
Trefz, Phillip;Schmidt, Sibylle C.;Fischer, Dagmar-Christiane
对呼出的挥发性有机化合物(VOC)的分析可能比现有的侵入性技术更快地提供系统信息。儿科1型糖尿病(T1 DM)的代谢异常具有很高的临床重要性，可以通过呼吸组学来解决。在高度标准化的环境下，将实时呼吸分析与连续血糖监测(CGM)和血液测试相结合，对患有T1 DM的儿童和年龄匹配的健康对照组进行了研究。CGM和呼吸分辨VOC分析每隔5分钟进行一次，持续9小时，并在预定的时间点采集血样。每个参与者(n=44)的食物摄入量和体力活动是相同的，总共调查了22个血液样本和93分钟的呼吸样本。血糖、胰岛素、胰高血糖素、瘦素和可溶性瘦素受体相对于食物摄入量的个体间变异性在患者和对照组之间有明显差异。在T1 DM患者中，丙酮、异丙醇和戊醛的呼出量与葡萄糖浓度相关。值得注意的是，这些相关性的强度强烈依赖于食物摄入和呼吸采样之间的间隔。我们的数据表明，通过餐后高血糖和相关的氧化应激进行的代谢适应立即反映在呼气VOC浓度上。我们发现的临床翻译可能会使在线呼吸分析对个性化医学的适用性成为可能。
An analysis of exhaled volatile organic compounds (VOC) may deliver systemic information quicker than available invasive techniques. Metabolic aberrations in pediatric type 1 diabetes (T1DM) are of high clinical importance and could be addressed via breathomics. Real-time breath analysis was combined with continuous glucose monitoring (CGM) and blood tests in children suffering from T1DM and age-matched healthy controls in a highly standardized setting. CGM and breath-resolved VOC analysis were performed every 5 minutes for 9 hours and blood was sampled at pre-defined time points. Per participant (n = 44) food intake and physical activity were identical and a total of 22 blood samples and 93 minutes of breath samples were investigated. The inter-individual variability of glucose, insulin, glucagon, leptin, and soluble leptin receptor relative to food intake differed distinctly between patients and controls. In T1DM patients, the exhaled amounts of acetone, 2-propanol, and pentanal correlated to glucose concentrations. Of note, the strength of these correlations strongly depended on the interval between food intake and breath sampling. Our data suggests that metabolic adaptation through postprandial hyperglycemia and related oxidative stress is immediately reflected in exhaled breath VOC concentrations. Clinical translations of our findings may enable point-of-care applicability of online breath analysis towards personalized medicine.