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Comparative Study
. 2015 Feb;10(1):23-9.
doi: 10.1111/j.2047-6310.2014.221.x. Epub 2014 Mar 27.

Breathprints of childhood obesity: changes in volatile organic compounds in obese children compared with lean controls

N Alkhouri  1 , K Eng, F Cikach, N Patel, C Yan, A Brindle, E Rome, I Hanouneh, D Grove, R Lopez, S L Hazen, Raed A Dweik
Affiliations
Comparative Study

Breathprints of childhood obesity: changes in volatile organic compounds in obese children compared with lean controls

N Alkhouri et al. Pediatr Obes. 2015 Feb.

Abstract

Objective: The objective of this study was to investigate changes in volatile organic compounds (VOCs) in exhaled breath in overweight/obese children compared with their lean counterparts.

Study design: Single exhaled breath was collected and analyzed per protocol using selective ion flow tube mass spectrometry (SIFT-MS).

Results: Sixty overweight/obese children and 55 lean controls were included. Compared with the lean group, the obese group was significantly older (14.1 ± 2.8 vs. 12.1 ± 3.0 years), taller (164.8 ± 10.9 vs. 153.3 ± 17.1 cm) and more likely to be Caucasian (60% vs. 35.2%); P < 0.05 for all. A comparison of the SIFT-MS results of the obese group with the lean group revealed differences in concentration of more than 50 compounds. A panel of four VOCs can identify the presence of overweight/obesity with excellent accuracy. Further analysis revealed that breath isoprene, 1-decene, 1-octene, ammonia and hydrogen sulfide were significantly higher in the obese group compared with the lean group (P value < 0.01 for all).

Conclusion: Obese children have a unique pattern of exhaled VOCs. Changes in VOCs observed in this study may help to gain insight into pathophysiological processes and pathways leading to the development of childhood obesity.

Keywords: Biomarker; breath testing; insulin resistance; oxidative stress.

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Conflict of interest statement

Conflict of Interest: No conflict of interest exists for any of the authors.

Figures

Figure 1
Figure 1. Training Set
1a. Canonical discriminant analysis using the identified four ion peaks: obese vs. lean subjects. Given two groups of observations (obese and lean) with measurements on several variables (VOCs), canonical discriminant analysis derives a linear combination of the variables that has the highest possible multiple correlation with the groups. The red dots represent obese children and the blue dots represent lean controls. 1b. ROC curve demonstrating excellent accuracy for predicting obesity with AUC of 0.994.
Figure 1
Figure 1. Training Set
1a. Canonical discriminant analysis using the identified four ion peaks: obese vs. lean subjects. Given two groups of observations (obese and lean) with measurements on several variables (VOCs), canonical discriminant analysis derives a linear combination of the variables that has the highest possible multiple correlation with the groups. The red dots represent obese children and the blue dots represent lean controls. 1b. ROC curve demonstrating excellent accuracy for predicting obesity with AUC of 0.994.
Figure 2
Figure 2. Validation Set
The same VOCs used in the training set can discriminate between obese and lean children with AUC of 0.935.
Figure 2
Figure 2. Validation Set
The same VOCs used in the training set can discriminate between obese and lean children with AUC of 0.935.
Figure 3
Figure 3. Volatile Organic Compound Levels in Obese and Lean Children
3a. Isoprene, a marker of cholesterol synthesis is markedly elevated in obese children. 3b and 3c. 1-Octene and 1-Decene, markers of increased oxidative stress are higher in obese children. 3d and 3e. Ammonia and hydrogen sulfide, markers of liver disease are elevated in childhood obesity.
Figure 3
Figure 3. Volatile Organic Compound Levels in Obese and Lean Children
3a. Isoprene, a marker of cholesterol synthesis is markedly elevated in obese children. 3b and 3c. 1-Octene and 1-Decene, markers of increased oxidative stress are higher in obese children. 3d and 3e. Ammonia and hydrogen sulfide, markers of liver disease are elevated in childhood obesity.
Figure 3
Figure 3. Volatile Organic Compound Levels in Obese and Lean Children
3a. Isoprene, a marker of cholesterol synthesis is markedly elevated in obese children. 3b and 3c. 1-Octene and 1-Decene, markers of increased oxidative stress are higher in obese children. 3d and 3e. Ammonia and hydrogen sulfide, markers of liver disease are elevated in childhood obesity.
Figure 4
Figure 4. Mass spectrometry peak of isoprene showing significant elevation in the obese group
A sample profile of mass scanning is shown for the NO+68+ peak (in red), which corresponds to the volatile organic compound of isoprene.
See this image and copyright information in PMC

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