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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).
Acetone in exhaled air is a potential biomarker of diabetes. In this paper, we used breath-based acetone analyzer based on cavity ringdown spectroscopy (CRDS) technique to detect type 2 diabetic (T2D) exhaled air Acetone concentration and quantitative analysis of acetone in patients with clinical indicators to explore the influence of acetone concentration in exhaled breath in order to provide a reference for the clinical application of respiration of diabetes mellitus.Respiratory acetone analyzer using CRDS measurement of 147 patients with T2D 81 exhaled breath samples of gas, 81 males, 66 females, ages 14-83) and 119 expired gas samples from 52 healthy individuals (30 males, 22 females, ages 20-48) with exhaled breath The correlations between the acetone concentrations and corresponding blood glucose (BG), glycohemoglobin A1C (A1C), sex, age, body mass index (BMI), prevalence of diabetes and gas sample collection , The correlation statistical analysis and the construction of multiple linear regression model of acetone.The results showed that gender, gas sample collection status, BMI, age, A1C and BG and other indicators of the impact of T2 D in patients with respiratory acetone concentration.Respiratory healthy women, the concentration of acetone and no gender, age and BMI.T2D patients with respiratory prophylaxis and BG and A1C have a weak correlation, correlation coefficients were 0.093 and 0.1246, respectively, the average volume fraction of male respiratory acetone (1.75 × 10-6) was significantly higher than that of females (1.15 × 10-6), and the concentration of respiratory acetone in men decreased with age (R = -0.154) .The concentration of respiratory acetone in men was negatively correlated with BMI = -0.2), and the mean respiratory acetone concentration (1.75 × 10-6) in patients with BMI <25 was significantly higher than that in patients with BMI> 25 (1.25 × 10-6). Female respiratory acetone concentration was positively correlated with the duration of illness = 0.17), but negatively correlated with male (R = -0.14) .The fasting respiration acetone concentration in both men and women was higher than that of 2 h postprandial respiration.Multivariate linear regression analysis showed that the factors affecting respiration acetone concentration were: (Β = -0.289), A1C (β = 0.083), BG (β = 0.002), BMI (β = -0.046) and age (β = -0.009).