摘要目的 了解糖尿病患者与健康志愿者空腹呼吸丙酮的分布差异,探索个体指标对空腹呼出气体中丙酮浓度的影响,研究空腹呼吸丙酮单个指标在糖尿病筛查中的作用.方法 利用基于光腔衰荡光谱(CRDS)技术的实时在线呼吸丙酮分析仪,对265名健康受试者、39例1型糖尿病(T1D)患者和300例2型糖尿病(T2D)患者进行空腹呼吸丙酮浓度测量,使用SPSS19.0软件剔除异常值后,与相应的性别、年龄、身高、体质量、身体质量指数(BMI)以及血糖浓度(BGL)等指标进行相关统计分析.应用受试者工作特征(ROC)曲线评价空腹呼吸丙酮浓度用于糖尿病的诊断价值.结果 T1D患者的平均空腹呼吸丙酮浓度[(2.24±1.43)×10-6]明显高于健康志愿者[(1.43±0.55)×10-6]与T2D患者[(1.410.73)×10-6],差异均具有统计学意义(均P＜0.05);男性糖尿病患者的平均空腹呼吸丙酮浓度均高于女性患者;健康志愿者的平均空腹呼吸丙酮浓度与年龄呈正相关(R=0.31,P＜0.01);T1D患者的平均空腹呼吸丙酮浓度与BMI呈正相关(R=0.33,P＜0.05);T2D患者的平均空腹呼吸丙酮浓度与身高呈正相关(R=0.18,P＜0.01).以空腹呼吸丙酮浓度诊断T1D的ROC曲线下面积为0.853,敏感度为71.9％,特异性为87.4％,P＜0.01;诊断T2D的ROC曲线下面积为0.528,敏感度为54.1％,特异性为55.0％,P＞0.05.结论 空腹呼吸丙酮浓度检测对T1D的诊断有意义,对T2D的诊断准确性较低且无统计学意义.

abstractsObjective To study the concentration distribution of acetone in fasting exhaled breath in diabetic patients and healthy subjects,to explore the effect of individual indexes on the concentration of acetone in fasting exhaled breath,and to study the role of individual indexes of fasting exhaled breath acetone in diabetes screening.Methods The acetone concentration measurements of fasting exhaled breath were performed on 265 healthy subjects,39 patients with type 1 diabetes (T1D),and 300 patients with type 2 diabetes (T2D) using real-time online respiratory acetone analyzer based on cavity ring-down spectroscopy (CRDS).SPSS 19.0 software was used to eliminate outliers,and relevant statistical analysis was carried out with the corresponding gender,age,height,body mass,body mass index (BMI) and blood glucose concentration (BGL).The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of fasting breath acetone concentration for diabetes diagnosing.Results The mean fasting breath acetone concentration in T1D patients was (2.24±1.43)×10-6 was significantly higher than (1.43±0.55)×10-6 in healthy subjects and (1.41±0.73)×10-6 in T2D patients,and the differences were statistically significant (all P＜0.05).The average fasting breath acetone concentration in male diabetic patients was higher than that in female patients.The mean fasting breath acetone concentration was positively correlated with age (R=0.31,P＜0.01) in healthy subjects,was positively correlated with BMI (R=0.33,P＜0.05) in T1D patients,and was positively correlated with height (R=0.18,P＜0.01) in T2D patients.The area under the ROC curve for the diagnosis of T1D by fasting breath acetone concentration was 0.853 with a sensitivity of 71.9％ and specificity of 87.4％ (P＜0.01),and for the diagnosis of T2D was 0.528 with a sensitivity of 54.1％ and specificity of 55.0％ (P＞0.05).Conclusions The detection of fasting breath acetone concentration is meaningful for T1D diagnosing,but has a low accuracy for T2D diagnosing (no statistically significant).