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J Appl Physiol (May 7, 2009). doi:10.1152/japplphysiol.91657.2008
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Submitted on December 30, 2008
Revised on April 6, 2009
Accepted on May 2, 2009

Improved Predictive Models for Plasma Glucose Estimation from Multi-Linear Regression Analysis of Exhaled Volatile Organic Compounds

Jane Lee1, Jerry Ngo1, Donald R. Blake1, Simone Meinardi1, Andria M. Pontello1, Robert L. Newcomb1, and Pietro R. Galassetti1*

1 University of California, Irvine

* To whom correspondence should be addressed. E-mail: pgalasse{at}uci.edu.

Exhaled volatile organic compounds (VOCs) represent ideal biomarkers of endogenous metabolism and could be used to non-invasively measure circulating variables, including plasma glucose. We have previously demonstrated that hyperglycemia in different metabolic settings (glucose ingestion in pediatric type 1 diabetes) is paralleled by changes in exhaled ethanol, acetone and methyl nitrate. In this study we have integrated these gas changes along with 3 additional VOCs (2 forms of xylene and ethylbenzene) into multi linear regression models to predict plasma glucose profiles in 10 healthy young adults, during the 2 hours following an i.v. glucose bolus (matched samples of blood, exhaled and room air were collected at 12 separate time points). The 4-gas model with highest predictive accuracy estimated plasma glucose in each subjects with a mean "R" value of 0.91 (range 0.70-0.98); increasing the number of VOCs in the model only marginally improved predictions (average "R" with best 5-gas model = 0.93; with 6-gas model = 0.95). While practical development of this methodology into clinically usable devices will require optimization of predictive algorithms on large-scale populations, our data prove the feasibility and potential accuracy of breath-based glucose testing.







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