Variation in Exhaled Acetone and Other Ketones in Patients Undergoing Bariatric Surgery: a Prospective Cross-sectional Study

Boshier, Piers R.; Fehervari, Matyas; Markar, Sheraz R.; Purkayastha, Sanjay; Španěl, Patrik; Smith, David

doi:10.1007/s11695-018-3180-5

Cited by 10 publications

(9 citation statements)

References 28 publications

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“…Given the lower BMI in the control group than in those with NAFLD, and because some compounds, such as breath acetone, have been shown to correlate with body weight, we adjusted each compound for BMI. 27 This was achieved by dividing the intensity of VOC by the corresponding BMI, before inclusion into the statistical modelling. 27 Significant differences persisted between the group with cirrhosis and the healthy control group for styrene, acetone, isoprene, DMS, D-limonene, acetophenone, and terpinene.…”

Section: Resultsmentioning

confidence: 99%

“… 27 This was achieved by dividing the intensity of VOC by the corresponding BMI, before inclusion into the statistical modelling. 27 Significant differences persisted between the group with cirrhosis and the healthy control group for styrene, acetone, isoprene, DMS, D-limonene, acetophenone, and terpinene. Isoprene is a by-product of cholesterol biosynthesis.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, we adjusted the measured VOC to BMI to provide a more accurate reflection of the metabolic profile because acetone, breath isoprene, 1-decene, 1-octene, ammonia, and hydrogen sulfide have been found to be influenced by body weight. 27 …”

Section: Discussionmentioning

confidence: 99%

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Volatomic analysis identifies compounds that can stratify non-alcoholic fatty liver disease

et al. 2020

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Background & aims Analysis of volatile organic compounds (VOCs) in exhaled breath, ‘volatomics’, provides opportunities for non-invasive biomarker discovery and novel mechanistic insights into a variety of diseases. The purpose of this pilot study was to compare breath VOCs in an initial cohort of patients with non-alcoholic fatty liver disease (NAFLD) and healthy controls. Methods Breath samples were collected from 15 participants with Child-Pugh class A NAFLD cirrhosis, 14 with non-cirrhotic NAFLD, and 14 healthy volunteers. Exhaled breath samples were collected using an established methodology and VOC profiles were analysed by gas chromatography-mass spectrometry. The levels of 19 VOCs previously associated with cirrhosis were assessed. Peaks of the VOCs were confirmed and integrated using Xcalibur® software, normalised to an internal standard. Receiver-operating characteristic (ROC) curves were used to determine the diagnostic accuracy of the candidate VOCs. Results Terpinene, dimethyl sulfide, and D-limonene provided the highest predictive accuracy to discriminate between study groups. Combining dimethyl sulfide with D-limonene led to even better discrimination of patients with NAFLD cirrhosis from healthy volunteers (AUROC 0.98; 95% CI 0.93–1.00; p <0.001) and patients with NAFLD cirrhosis from those with non-cirrhotic NAFLD (AUROC 0.91; 95% CI 0.82–1.00; p <0.001). Breath terpinene concentrations discriminated between patients with non-cirrhotic NAFLD and healthy volunteers (AUROC 0.84; 95% CI 0.68–0.99; p = 0.002). Conclusion Breath terpinene, dimethyl sulfide, and D-limonene are potentially useful volatomic markers for stratifying NAFLD; in addition, a 2-stage approach enables the differentiation of patients with cirrhosis from those without. However, these observations require validation in a larger NAFLD population. ( ClinicalTrials.gov Identifier: NCT02950610 ). Lay summary Breath malodour has been associated with a failing liver since the ancient Greeks. Analytical chemistry has provided us an insight into ubiquitous volatile organic compounds associated with liver (and other) diseases. This has vastly improved our understanding of the mechanistic processes of liver damage. Our study aims to identify volatile organic compounds which are specific to non-alcoholic fatty liver disease and that can be exploited for rapid diagnostics.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Volatomic analysis identifies compounds that can stratify non-alcoholic fatty liver disease

et al. 2020

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“…После бариатрической операции ткани и органы находятся в состоянии энергетического голода. В этой ситуации благодаря возбуждению метаболических центров в ЦНС импульсами с хеморецепторов клеток, испытывающих энергетический голод, резко усиливаются липолиз, и происходит мобилизация большого количества жирных кислот из жировых депо в печень [128]. В печени происходит интенсивное образование кетоновых тел.…”

Section: обсуждение полученных результатовunclassified

“…Концентрация жирных кислот в крови увеличивается в 3-4 раза по сравнению с постабсорбтивным состоянием, а уровень кетоновых тел в крови через неделю после голодания повышается в 10-15 раз [124]. В бариатрической хирургии описано исследование с определением концентрации кетонов в дыхательном анализаторе с помощью спектрометрии с ионной проточной трубкой [128]. Полученные данные подтверждают, что исследование кетонов в выдыхаемом воздухе, особенно ацетона, является потенциально клинически полезным методом неинвазивной оценки энергетического питания у пациентов с ожирением.…”

Section: обсуждение полученных результатовunclassified

Концепция Бесстеплерного Гастрошунтирования

Оспанов¹,

Нао²,

Астана³

2019

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Баймаханов Болатбек Бимендеевич, доктор медицинских наук, профессор медицины, председатель Правления АО "Национальный научный центр хирургии" им. А.Н. Сызганова, член-корреспондент Национальной Академии наук Республики Казахстан, академик Российской Академии медицинских наук, член Всемирной Ассоциации хирургов-гепатологов, вице-президент Ассоциации гепатопанкреатобилиарных хирургов стран СНГ, г. Алматы, Казахстан. Ержанов Омаркан Нурканович, доктор медицинских наук, профессор медицины, профессор кафедры хирургических болезней Карагандинского государственного медицинского университета, действительный член Всемирной федерации хирургии ожирения и метаболических нарушений (IFSO), г. Караганда, Казахстан.

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Measuring ketone bodies for the monitoring of pathologic and therapeutic ketosis

Anderson

Mattar

Greenway

et al. 2021

Obesity Science & Practice

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Background The ketone bodies β‐hydroxybutyrate (BOHB) and acetone are generated as a byproduct of the fat metabolism process. In healthy individuals, ketone body levels are ∼0.1 mM for BOHB and ∼1 part per million for breath acetone (BrAce). These levels can increase dramatically as a consequence of a disease process or when used therapeutically for disease treatment. For example, increased ketone body concentration during weight loss is an indication of elevated fat metabolism. Ketone body measurement is relatively inexpensive and can provide metabolic insights to help guide disease management and optimize weight loss. Methods This review of the literature provides metabolic mechanisms and typical concentration ranges of ketone bodies, which can give new insights into these conditions and rationale for measuring ketone bodies. Results Diseases such as heart failure and ketoacidosis can affect caloric intake and macronutrient management, which can elevate BOHB 30‐fold and BrAce 1000‐fold. Other diseases associated with obesity, such as brain dysfunction, cancer, and diabetes, may cause dysfunction because of an inability to use glucose, excessive reliance on glucose, or poor insulin signaling. Elevating ketone body concentrations (e.g., nutritional ketosis) may improve these conditions by forcing utilization of ketone bodies, in place of glucose, for fuel. During weight loss, monitoring ketone body concentration can demonstrate program compliance and can be used to optimize the weight‐loss plan. Conclusions The role of ketone bodies in states of pathologic and therapeutic ketosis indicates that accurate measurement and monitoring of BOHB or BrAce will likely improve disease management. Bariatric surgery is examined as a case study for monitoring both types of ketosis.

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Variation in Exhaled Acetone and Other Ketones in Patients Undergoing Bariatric Surgery: a Prospective Cross-sectional Study

Abstract: Findings confirm breath ketones, particularly acetone, to be a potentially clinically useful method of non-invasive nutritional assessment in obese patients.

Cited by 10 publications

References 28 publications

Volatomic analysis identifies compounds that can stratify non-alcoholic fatty liver disease

Volatomic analysis identifies compounds that can stratify non-alcoholic fatty liver disease

Концепция Бесстеплерного Гастрошунтирования

Measuring ketone bodies for the monitoring of pathologic and therapeutic ketosis

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