Breath acetone change during aerobic exercise is moderated by cardiorespiratory fitness.

OBJECTIVES Investigation of exhaled breath acetone (BrAce) during and after submaximal aerobic exercise as a volatile biomarker for metabolic responsiveness in high and lower-fit individuals. DESIGN Prospective cohort pilot-study. METHODS Twenty healthy adults (19-39 years) with different levels of cardiorespiratory fitness (VO2peak), determined by spiroergometry, were recruited. BrAce was repeatedly measured by proton-transfer-reaction time-of-flight mass spectrometry (PTR-TOF-MS) during 40 - 55 min submaximal cycling exercise and a post-exercise period of 180 min. Activity of ketone- and fat metabolism during and after exercise were assessed by indirect calorimetric calculation of fat oxidation rate and by measurement of venous β-hydroxybutyrate (βHB). RESULTS Maximum BrAce ratios were significantly higher during exercise in the high-fit individuals compared to the lower-fit group (t-test;p=0.03). Multivariate regression showed 0.4% (95%-CI=-0.2 - 0.9%,p=0.155) higher BrAce change during exercise for every ml kg-1min-1higher VO2peak. Differences of BrAce ratios during exercise were similar to fat oxidation rate changes, but without association to respiratory minute-volume. Furthermore, the high-fit group showed higher maximum BrAce increase rates (46% h-1) in the late post-exercise phase compared to the lower-fit group (29% h-1). CONCLUSIONS High-fit young, healthy individuals have a higher increase in BrAce concentrations related to submaximal exercise than lower-fit subjects, indicating a stronger exercise-related activation of fat metabolism.