Evaluation of the Fasting Level of the Expired Alveolar Acetone Concentration

Abstract

In metabolic disorders, such as diabetic ketoacidosis, it is well known that a characteristic breath order is one of the distinct symptoms of patients. In view of this we have engaged in the quantitative analysis of acetone concentrations in the expired alveolar air (alv-Ac) using the gas chromatographic method. Venous blood β-hydroxybutyrate (B-βHB) was also determined using the enzymatic method. In the normal subjects, the fasting level of alv-Ac was 0.9+0.3, μg/L (n=39) and B-βHB was 0.06±0.07mM (n=33). In the diabetic patients, the levels of both alv-Ac (2.37±2.40, μg/L) and B-βHB (0.283±0.204mM) (n=9) were higher than in the normal subjects. Thus, a correlation was shown (r=0.9626). A subject with diabetes mellitus accompanied with hyperthyroidism has also been described in whose case an improvement of the fasting level of alv-Ac and B-βHB parallel with an improvement in the level of blood sugar was observed during his period under treatment with insulin and an antithyroid drug.
In patients with hyperthyroidism, the level of alv-Ac was unexpectedly high (2.96±2.71μg/ L) (n=8), especially in two cases: 7.2 and 6.9, μg/L, respectively.
Hereafter, changes in blood and urinary ketone bodies should be reevaluated in comparison with alv-Ac levels under various conditions.