Monday, February 25, 2013

Breath acetone as a biomarker in heart failure

It performed comparably to BNP/proBNP in this study, both in diagnosis and severity assessment.

The incredible and never adequately explored potential of breath acetone (BA) analysis for clinical application has long been a pet interest of mine. As a medical student I got to spend my summers playing with the gas chromatograph machine in Oscar B. Crofford's lab. Although the focus of that research was diabetes and obesity BA has potential application as a biomarker in a variety of disease states. This is best appreciated by understanding that BA reflects lipolytic activity; it is, as Dr. Crofford was fond of saying, the “smoke of burning fat.” That in turn reflects the balance between insulin and counter regulatory hormone activity on hormone sensitive lipase located in adipose tissue cells. The counter regulatory hormones are the stress hormones: epinephrine, norepinephrine, growth hormone, glucagon and cortisol. So elevated BA reflects the catabolic state and/or the ratio of activities of stress hormones to insulin.

The methodology is simple, specimen collection is easy (the patient can exhale into a syringe) and turn around is instantaneous. BA analysis deserves further study in a variety of clinical situations.

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