{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:19:07Z","timestamp":1780053547836,"version":"3.54.0"},"reference-count":44,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2016,7,30]],"date-time":"2016-07-30T00:00:00Z","timestamp":1469836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Science Foundation of China","doi-asserted-by":"publisher","award":["81471701"],"award-info":[{"award-number":["81471701"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Breath analysis has been considered a suitable tool to evaluate diseases of the respiratory system and those that involve metabolic changes, such as diabetes. Breath acetone has long been known as a biomarker for diabetes. However, the results from published data by far have been inconclusive regarding whether breath acetone is a reliable index of diabetic screening. Large variations exist among the results of different studies because there has been no \u201cbest-practice method\u201d for breath-acetone measurements as a result of technical problems of sampling and analysis. In this mini-review, we update the current status of our development of a laser-based breath acetone analyzer toward real-time, one-line diabetic screening and a point-of-care instrument for diabetic management. An integrated standalone breath acetone analyzer based on the cavity ringdown spectroscopy technique has been developed. The instrument was validated by using the certificated gas chromatography-mass spectrometry. The linear fittings suggest that the obtained acetone concentrations via both methods are consistent. Breath samples from each individual subject under various conditions in total, 1257 breath samples were taken from 22 Type 1 diabetic (T1D) patients, 312 Type 2 diabetic (T2D) patients, which is one of the largest numbers of T2D subjects ever used in a single study, and 52 non-diabetic healthy subjects. Simultaneous blood glucose (BG) levels were also tested using a standard diabetic management BG meter. The mean breath acetone concentrations were determined to be 4.9 \u00b1 16 ppm (22 T1D), and 1.5 \u00b1 1.3 ppm (312 T2D), which are about 4.5 and 1.4 times of the one in the 42 non-diabetic healthy subjects, 1.1 \u00b1 0.5 ppm, respectively. A preliminary quantitative correlation (R = 0.56, p &lt; 0.05) between the mean individual breath acetone concentration and the mean individual BG levels does exist in 20 T1D subjects with no ketoacidosis. No direct correlation is observed in T1D subjects, T2D subjects, and healthy subjects. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone, under a specifically controlled condition fast (&lt;1 min) and portable breath acetone measurement can be used for screening abnormal metabolic status including diabetes, for point-of-care monitoring status of ketone bodies which have the signature smell of breath acetone, and for breath acetone related clinical studies requiring a large number of tests.<\/jats:p>","DOI":"10.3390\/s16081199","type":"journal-article","created":{"date-parts":[[2016,8,3]],"date-time":"2016-08-03T03:47:39Z","timestamp":1470196059000},"page":"1199","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["A Portable Real-Time Ringdown Breath Acetone Analyzer: Toward Potential Diabetic Screening and Management"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8790-9185","authenticated-orcid":false,"given":"Chenyu","family":"Jiang","sequence":"first","affiliation":[{"name":"Institute of Biomedical Engineering, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Tianjin 300192, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meixiu","family":"Sun","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Tianjin 300192, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhennan","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Tianjin 300192, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuying","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Tianjin 300192, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Tianjin 300192, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Yuan","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Tianjin 300192, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingxin","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Tianjin 300192, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuji","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Tianjin 300192, China"},{"name":"Department of Physics and Astronomy, Mississippi State University, Starkville, MS 39759, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,7,30]]},"reference":[{"key":"ref_1","first-page":"961","article-title":"Analysis of organic compounds in human breath by gas chromatography-mass spectrometry lab","volume":"74","author":"Jansson","year":"1969","journal-title":"Clin. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1073\/pnas.68.10.2374","article-title":"Quantitative analysis of urine vapor and breath by gas-liquid partition chromatography","volume":"68","author":"Pauling","year":"1971","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1093\/clinchem\/31.8.1278","article-title":"Volatile organic compounds in exhaled air from patients with lung cancer","volume":"31","author":"Gordon","year":"1985","journal-title":"Clin. Chem."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s00340-006-2280-4","article-title":"Current status of clinicalbreath analysis","volume":"85","author":"Risby","year":"2006","journal-title":"Appl. Phys. B"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1364\/OPN.16.1.000030","article-title":"Breath diagnostics using laser spectroscopy","volume":"16","year":"2005","journal-title":"Opt. Photonics News"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Wang, Z., and Wang, C. (2013). Is breath acetone a biomarker of diabetes\u2014A historical review on breath acetone measurements. J. Breath Res., 7.","DOI":"10.1088\/1752-7155\/7\/3\/037109"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/S0140-6736(66)92194-5","article-title":"Acetone in alveolar air, and the control of diabetes","volume":"288","author":"Rooth","year":"1966","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1203\/00006450-199809000-00016","article-title":"Exhaled isoprene and acetone in newborn infants and in children with diabetes mellitus","volume":"44","author":"Nelson","year":"1998","journal-title":"Pediatr. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1088\/0967-3334\/24\/1\/308","article-title":"Time variation of ammonia, acetone, isoprene and ethanol in breath: A quantitative SIFT-MS study over 30 days","volume":"24","author":"Diskin","year":"2003","journal-title":"Physiol. Meas."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Smith, D., Span\u011bl, P., Fryer, A.A., Hanna, F., and Ferns, G.A. (2011). Can volatile compounds in exhaled breathbe used to monitor control in diabetes mellitus?. J. Breath Res., 5.","DOI":"10.1088\/1752-7155\/5\/2\/022001"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1088\/0967-3334\/27\/4\/001","article-title":"A longitudinal study of ammonia, acetone and propanol in the exhaled breath of 30 subjects using selected ion flow tube mass spectrometry, SIFT-MS","volume":"27","author":"Turner","year":"2006","journal-title":"Physiol. Meas."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.aca.2004.12.018","article-title":"Determination of acetone in breath","volume":"535","author":"Teshima","year":"2005","journal-title":"Anal. Chim. Acta"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1152\/japplphysiol.00868.2005","article-title":"Measuring airway exchange of endogenous acetone using a single-exhalation breathing maneuver","volume":"100","author":"Anderson","year":"2006","journal-title":"J. Appl. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.aca.2014.03.014","article-title":"Solid-state gas sensors for breath analysis: A review","volume":"824","author":"Natale","year":"2014","journal-title":"Anal. Chim. Acta"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1021\/ac504235e","article-title":"Study of the exhaled acetone in type 1 diabetes using quantum cascade laser spectroscopy","volume":"87","author":"Horsten","year":"2015","journal-title":"Anal. Chem."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1002\/oby.21242","article-title":"Measuing breath acetone for minitoring fat loss: Review","volume":"23","author":"Anderson","year":"2015","journal-title":"Obesity"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Li, W., Liu, Y., Lu, X., Huang, Y., Liu, Y., Cheng, S., and Duan, Y. (2015). A cross-sectional study of breath acetone based on diabetic metabolic disorders. J. Breath Res., 9.","DOI":"10.1088\/1752-7155\/9\/1\/016005"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1109\/JSEN.2009.2035736","article-title":"Endogenouslevels of five fatty acid metabolites in exhaled breath condensate to monitor asthma by high-performance liquid chromatography: Electrospray tandem mass spectrometry","volume":"10","author":"Nording","year":"2010","journal-title":"IEEE Sens. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2908","DOI":"10.1002\/jssc.201200333","article-title":"Chemotherapy control by breath profile with application of SPME-GC\/MS method","volume":"35","author":"Ulanowska","year":"2012","journal-title":"J. Sep. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1093\/jat\/24.8.718","article-title":"Automated in-tube solid phase micro extraction coupled with liquid chromatography-electrospray ionization mass spectrometry for the determination of selected benzodiazepines","volume":"24","author":"Yuan","year":"2000","journal-title":"J. Anal. Toxicol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1088\/0967-3334\/23\/3\/301","article-title":"On-line, simultaneous quantification of ethanol, some metabolites and water vapour in breath following the ingestion of alcohol","volume":"23","author":"Smith","year":"2002","journal-title":"Physiol. Meas."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1093\/bja\/aeg271","article-title":"Real-time breath monitoring of propane and its volatile metabolites during surgery using a novel mass spectrometric technique: A feasibility study","volume":"91","author":"Harrison","year":"2003","journal-title":"Br. J. Anaesth."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.resp.2004.02.002","article-title":"Mass spectrometric profile of exhaled breath-field study by PTR-MS","volume":"145","author":"Moser","year":"2005","journal-title":"Respir. Physiol. Neurobiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.chroma.2005.01.055","article-title":"Detection of human metabolites using multi-capillary columns coupled to ion mobility spectrometers","volume":"1084","author":"Ruzsanyi","year":"2005","journal-title":"J. Chromatogr. A"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1007\/s00216-015-9170-8","article-title":"A novel method for the determination of three volatile organic compounds in exhaled breath by solid-phase microextraction-ion mobility spectrometry","volume":"408","author":"Allafchian","year":"2016","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1002\/mas.20033","article-title":"Selected ion flow tube mass spectrometry (SIFT-MS) for on-line trace gas analysis","volume":"24","author":"Smith","year":"2005","journal-title":"Mass Spectrom. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Lei, J., Hou, C., Huo, D., Luo, X., Bao, M., Li, X., Yang, M., and Fa, H. (2015). A novel device based on a fluorescent cross-responsive sensor array for detecting lung cancer related volatile organic compounds. Rev. Sci. Instrum., 86.","DOI":"10.1063\/1.4907628"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tisch, U., and Haick, H. (2014). Chemical sensors for breath gas analysis: The latest developments at the breath analysis summit 2013. J. Breath Res., 8.","DOI":"10.1088\/1752-7155\/8\/2\/027103"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"8230","DOI":"10.3390\/s91008230","article-title":"Breath analysis using laser spectroscopy techniques: Breath biomarkers, spectral fingerprints, and detection limits","volume":"9","author":"Wang","year":"2009","journal-title":"Sensors"},{"key":"ref_30","unstructured":"Wang, C. (2005, January 1\u20134). Biomedical applications of cavity ringdown spectroscopy: Present and perspective. Proceedings of the 57th Southeast\/61st Southwest Joint Regional Meeting of the American Chemical Society, Memphis, TN, USA."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2544","DOI":"10.1063\/1.1139895","article-title":"Cavity ring-down optical spectrometer for absorption measurements using pulsed laser sources","volume":"59","author":"Deacon","year":"1988","journal-title":"Rev. Sci. Instrum."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1080\/014423500750040627","article-title":"Cavity ring-down spectroscopy: Experimental schemes and applications","volume":"22","author":"Berden","year":"2000","journal-title":"Int. Rev. Phys. Chem."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s00340-008-3077-4","article-title":"A novel multiple species ringdown spectrometer for in situ measurements of methane, carbon dioxide, and carbon isotope","volume":"92","author":"Wang","year":"2008","journal-title":"Appl. Phys. B"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Berden, G., and Engeln, R. (2009). Cavity Ring-Down Spectroscopy: Techniques and Applications, Wiley-Blackwell.","DOI":"10.1002\/9781444308259"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1109\/JSEN.2009.2035730","article-title":"A study on breath acetone in diabetic patients using a cavity ringdown breath analyzer: Exploring correlations of breath acetone with blood glucose and glycohemoglobin A1C","volume":"10","author":"Wang","year":"2010","journal-title":"IEEE Sens. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1021\/ac3031465","article-title":"Demonstration of a mid-infrared cavity enhanced absorption spectrometer for breath acetone detection","volume":"85","author":"Ciaffoni","year":"2013","journal-title":"Anal. Chem."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Wang, C., and Surampudi, A.B. (2008). An acetone breath analyzer using cavity ringdown spectroscopy: An initial test with human subjects under various situations. Meas. Sci. Technol., 22.","DOI":"10.1088\/0957-0233\/19\/10\/105604"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.1088\/0957-0233\/18\/8\/051","article-title":"A new acetone detection device using cavity ringdown spectroscopy at 266 nm: Evaluation of the instrument performance using acetone sample solutions","volume":"18","author":"Wang","year":"2007","journal-title":"Meas. Sci. Technol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1007\/s00216-014-8401-8","article-title":"Determination of breath acetone in 149 type 2 diabetic patients using a ringdown breath-acetone analyzer","volume":"407","author":"Sun","year":"2015","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1109\/JSEN.2013.2293705","article-title":"Breath acetone analysis of diabetic dogs using a cavity ringdown breath analyzer","volume":"14","author":"Wang","year":"2013","journal-title":"IEEE Sens. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"71002","DOI":"10.1039\/C5RA07084H","article-title":"Study of breath acetone and its correlations with blood glucose and blood beta-hydroxybutyrate using an animal model with lab-developed type 1 diabetic rat","volume":"5","author":"Sun","year":"2015","journal-title":"RSC Adv."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"8170","DOI":"10.3390\/s130708170","article-title":"Measurements of the weak UV absorptions of isoprene and acetone at 261\u2013275 nm using cavity ringdown spectroscopy for evaluation of a potential portable ringdown breath analyzer","volume":"13","author":"Sahay","year":"2013","journal-title":"Sensors"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Gong, Z., Sun, M., Jiang, C., Wang, Z., Kang, M., Li, Y., and Wang, C. (2014). A ringdown breath acetone analyzer: Performance and validation using gas chromatography-mass spectrometry. J. Anal. Bioanal. Tech., S7.","DOI":"10.4172\/2155-9872.S7-013"},{"key":"ref_44","first-page":"21","article-title":"Cost of self-monitoring of blood glucose in the United States among patients on an insulin regimen for diabetes","volume":"18","author":"Yeaw","year":"2012","journal-title":"J. Manag. Care Pharm."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/16\/8\/1199\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:27:25Z","timestamp":1760210845000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/16\/8\/1199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,30]]},"references-count":44,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2016,8]]}},"alternative-id":["s16081199"],"URL":"https:\/\/doi.org\/10.3390\/s16081199","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,30]]}}}