Abstract
Variations in the isotopic signature of carbon in biological samples (e.g. breath, blood and tissues) can be used to monitor shifts in whole body metabolism. As a conservative recorder of our diet, changes in the isotopic signature of carbon in biological samples provide an objective means to distinguish dietary patterns and the relationship with diseases. In addition, metabolic discrimination of carbon within the body can be informative regarding changes in the body's metabolic fuel usage during situations where shifts in the macronutrient oxidation ratio are expected. Therefore, changes in the isotopic signature over time have proven to be a tremendously powerful and sensitive means of detecting and measuring changes in steady-state systems. As such, this review focuses on how a naturally occurring ratio of stable isotopes of carbon (13C/12C) can be used as a biomarker for nutritional and metabolic status, altered macronutrient metabolism, and health and disease.
Highlights
Carbon dioxide has long been used as a marker for health and disease,[1] and the 13C/12C ratio re ects changes in diet and metabolism.[2,3,4] Measurement of carbon in exhaled breath has progressed from the advent of capnography in the 18th century by Tyndall using infrared light absorption to measurement of the stable isotopes of carbon by isotope ratio mass spectrometry in the 19th century to recent advances in instrumentation that make the carbon stable isotope ratio in exhaled breath a viable biomarker for health and disease
Within the past 50 years, scientists have demonstrated that further insights into alterations in body metabolism can be gained by measuring the ratio of the stable isotopes of carbon (i.e. 13C/12C) in exhaled CO2, termed the breath delta value or BDV.[2,3,4]
Diet in uences baseline BDV on a population scale,[2] changes in the BDV over time within an individual can shed light on changes in the ratio of macronutrient oxidation,[2] as well as the acute phase response to infection due to fractionation.[3,4,6]
Summary
The emerging role of carbon isotope ratio determination in health research and medical diagnostics Cite this: J. Variations in the isotopic signature of carbon in biological samples (e.g. breath, blood and tissues) can be used to monitor shifts in whole body metabolism. As a conservative recorder of our diet, changes in the isotopic signature of carbon in biological samples provide an objective means to distinguish dietary patterns and the relationship with diseases. Metabolic discrimination of carbon within the body can be informative regarding changes in the body's metabolic fuel usage during situations where shifts in the macronutrient oxidation ratio are expected. This review focuses on how a naturally occurring ratio of stable isotopes of carbon (13C/12C) can be used as a biomarker for nutritional and metabolic status, altered macronutrient metabolism, and health and disease
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