Breath Acetone Correlates With Capillary β-hydroxybutyrate in Type 1 Diabetes.

Area of Science:

• Endocrinology
• Metabolic Disorders
• Biomarker Discovery

Background:

• Breath acetone (BrACE) is a metabolic byproduct of ketone bodies.
• Noninvasive breath ketone analyzers can measure BrACE.
• Type 1 diabetes management involves monitoring ketone levels.

Purpose of the Study:

• To assess the correlation between capillary blood β-hydroxybutyrate (BOHB) and BrACE.
• To evaluate this correlation in type 1 diabetes patients under different care conditions.
• To determine the utility of BrACE as a noninvasive BOHB marker.

Main Methods:

• Randomized crossover study design.
• 14-day outpatient periods with and without dapagliflozin.
• Supervised 1-day insulin withdrawal studies.
• Paired BOHB and BrACE measurements.
• Spearman's rank correlation coefficient (ρ) analysis.

Main Results:

• Moderate correlation between BrACE and BOHB during outpatient care (ρ = .41).
• Strong correlation between BrACE and BOHB during insulin withdrawal (ρ = .81).
• BrACE > 5 ppm showed high sensitivity (93%) and specificity (87%) for detecting BOHB ≥ 1.5 mmol/L.

Conclusions:

• Breath acetone measurement offers a noninvasive estimate of blood BOHB in type 1 diabetes.
• BrACE correlation with BOHB is suboptimal during unsupervised outpatient care.
• BrACE shows strong correlation with BOHB during supervised insulin withdrawal.