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Proc Natl Acad Sci U S A


Title:Exhaled methyl nitrate as a noninvasive marker of hyperglycemia in type 1 diabetes
Author(s):Novak BJ; Blake DR; Meinardi S; Rowland FS; Pontello A; Cooper DM; Galassetti PR;
Address:"Department of Chemistry, University of California, Irvine, CA 92697, USA"
Journal Title:Proc Natl Acad Sci U S A
Year:2007
Volume:20070925
Issue:40
Page Number:15613 - 15618
DOI: 10.1073/pnas.0706533104
ISSN/ISBN:0027-8424 (Print) 1091-6490 (Electronic) 0027-8424 (Linking)
Abstract:"Recent technical advances allow detection of several hundred volatile organic compounds (VOCs) in human exhaled air, many of which reflect unidentified endogenous pathways. Our group has previously estimated plasma glucose levels in healthy adults during a standard oral glucose tolerance test via exhaled VOC analysis. As a result of the metabolic characteristics of hyperglycemia in the diabetic (low insulin and increased free fatty acids and ketones), we hypothesized that different exhaled VOC profiles may be present in children with type 1 diabetes mellitus (T1DM) during spontaneous hyperglycemia. Exhaled methyl nitrate strongly correlated specifically with the acute, spontaneous hyperglycemia of T1DM children. Eighteen experiments were conducted among 10 T1DM children. Plasma glucose and exhaled gases were monitored during either constant euglycemia (n = 5) or initial hyperglycemia with gradual correction (n = 13); all subjects received i.v. insulin and glucose as needed. Gas analysis was performed on 1.9-liter breath samples via gas chromatography using electron capture, flame ionization, and mass selective detection. Among the approximately 100 measured exhaled gases, the kinetic profile of exhaled methyl nitrate, commonly present in room air in the range of 5-10 parts per trillion, was most strongly statistically correlated with that of plasma glucose (P = 0.003-0.001). Indeed, the kinetic profiles of the two variables paralleled each other in 16 of 18 experiments, including repeat subjects who at different times displayed either euglycemia or hyperglycemia"
Keywords:"Biomarkers/analysis Blood Glucose/analysis/drug effects/metabolism *Breath Tests Child Diabetes Mellitus, Type 1/*blood/drug therapy Exhalation Gases/analysis Humans Hyperglycemia/*diagnosis Hypoglycemic Agents/therapeutic use Insulin/therapeutic use Nitr;"
Notes:"MedlineNovak, B J Blake, D R Meinardi, S Rowland, F S Pontello, A Cooper, D M Galassetti, P R eng K23 RR018661/RR/NCRR NIH HHS/ M01 RR000827/RR/NCRR NIH HHS/ K23 RR018661-01/RR/NCRR NIH HHS/ M01 RR00827-28/RR/NCRR NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2007/09/27 Proc Natl Acad Sci U S A. 2007 Oct 2; 104(40):15613-8. doi: 10.1073/pnas.0706533104. Epub 2007 Sep 25"

 
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