2型糖尿病患者呼吸丙酮影响因素分析
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中国医学科学院 北京协和医学院生物医学工程研究所,中国医学科学院 北京协和医学院生物医学工程研究所,中国医学科学院 北京协和医学院生物医学工程研究所,中国医学科学院 北京协和医学院生物医学工程研究所,中国医学科学院 北京协和医学院生物医学工程研究所,中国医学科学院 北京协和医学院生物医学工程研究所,中国医学科学院 北京协和医学院生物医学工程研究所,中国医学科学院 北京协和医学院生物医学工程研究所,中国医学科学院 北京协和医学院生物医学工程研究所

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国家自然科学基金面上项目(81471701)


Influencing Factors on Breath Acetone in Type 2 Diabetic Patients
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Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College,Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College,Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College,Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College,Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College,Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College,Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College,Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College,Institute of Biomedical Engineering,Chinese Academy of Medical Science Peking Union Medical College

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This work was supported by a grant from The National Natural Science Foundation of China(81471701)

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    摘要:

    呼出气中的丙酮是糖尿病的潜在生物标志物,本文利用基于光腔衰荡光谱(cavity ringdown spectroscopy,CRDS)技术的呼吸丙酮分析仪对2型糖尿病患者(type 2 diabetic,T2D)呼出气中的丙酮浓度进行定量测量,分析丙酮与患者临床指标的关系,探索影响呼出气中丙酮浓度的因素,以期为糖尿病呼吸丙酮的临床应用提供参考.利用CRDS技术的呼吸丙酮分析仪测量147名T2D患者(81名男性,66名女性,年龄14~83岁)的512个呼出气体样品和 52名健康人(30名男性,22名女性,年龄20~48岁)的119个呼出气体样品.对呼出气中的丙酮浓度与相应的血糖(blood glucose,BG)、糖化血红蛋白(glycohemoglobin A1C,A1C)、性别、年龄、身体质量指数(body mass index,BMI)、糖尿病患病年限及气体样本采集状态等指标,进行相关性统计分析并构建丙酮的多元线性回归模型.结果表明,性别、气体样本采集状态、BMI、年龄、A1C及BG等指标影响T2D患者的呼吸丙酮浓度.健康人呼吸丙酮浓度与性别、年龄及BMI无相关关系.T2D患者呼吸丙酮与BG及A1C均有弱相关关系,相关系数分别为0.093和0.1246.男性呼吸丙酮平均体积分数(1.75×10-6)显著性高于女性(1.15×10-6),且男性呼吸丙酮浓度随年龄的升高而降低(R=-0.154).男性呼吸丙酮浓度与BMI呈负相关(R=-0.2),且BMI<25的患者呼吸丙酮平均体积分数(1.75×10-6)高于BMI > 25的患者(1.25×10-6).女性呼吸丙酮浓度与患病年限呈正相关(R=0.17),而男性呈负相关(R=-0.14).男性和女性空腹呼吸丙酮浓度均高于餐后2 h的呼吸丙酮浓度.多元线性回归分析结果表明,影响呼吸丙酮浓度的因素为:性别(β= 0.374)、气体样本采集状态(β= -0.289)、A1C(β= 0.083)、BG(β= 0.002)、BMI(β= -0.046)及年龄(β= -0.009).

    Abstract:

    This paper explores the quantitative correlation between diabetes and breath acetone and analyzes the factors influencing breath acetone concentration. It aims to provide reference values for the application of breath acetone analysis in diabetic testing. We utilized a pilot-scale breath acetone analyzer based on the cavity ringdown spectroscopy (CRDS) technique to conduct breath tests with 512 breath samples from 147 type 2 diabetic patients (81 male, 66 female, age 14~83 years) and 119 breath samples from 52 healthy individuals (30 male, 22 female, age 20~48 years). Relations between breath acetone and blood glucose (BG) and glycohemoglobin A1C (A1C) and several other clinical indices, such as gender, age, Body Mass Index (BMI), years of diabetes and breath samples' collection conditions were investigated. The multi-variation linear regression model was also constructed to explore the influencing factors of breath acetone. No correlations were observed between breath acetone and gender, age or BMI in 52 healthy people tested. Breath acetone concentration in the T2D subjects studied in this work was correlated with both BG (R=0.093) and A1C levels (R=0.1246). Breath Acetone concentration was significantly higher in male subjects (1.75×10-6) than female subjects (1.15×10-6), and male subjects' breath acetone was clearly increased with decreasing age (R=-0.154). Besides, breath acetone concentration was significantly correlated inversely with BMI (R=-0.2) in male subjects, and significantly higher in subjects with BMI under 25 (1.75×10-6) than obese subjects with BMI over 25 (1.25×10-6). Breath acetone was correlated positively with years of diabetes in female subjects (R=0.17,). Whereas, negatively correlated in male subjects (R=-0.14). Furtherrnore, there were variations in relation to breath samples' collection conditions in both male and female subjects. Multi-variation analysis showed that gender (β=0.374)、A1C (β=0.083)、BG (β=0.002)、breath samples' collection conditions (β=-0.289)、BMI (β=-0.046) and age (β=-0.009) affect breath acetone concentrations. In conclusion, breath acetone concentration was correlated with gender, breath samples' collection conditions, BMI, age, A1C and BG.

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陈珠英,孙美秀,龚智勇,袁渊,赵晓萌,刘伟超,姜琛昱,王振南,李迎新.2型糖尿病患者呼吸丙酮影响因素分析[J].生物化学与生物物理进展,2015,42(5):483-490

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  • 收稿日期:2014-10-29
  • 最后修改日期:2015-03-25
  • 接受日期:2015-03-26
  • 在线发布日期: 2015-05-22
  • 出版日期: 2015-05-20