GC-MS analysis of breath odor compounds in liver patients

J Chromatogr B Analyt Technol Biomed Life Sci. 2008 Nov 15;875(2):344-8. doi: 10.1016/j.jchromb.2008.08.031. Epub 2008 Sep 17.


Background: Liver diseases can cause a sweet, musty aroma of the breath, called fetor hepaticus. Even in a stage of cirrhosis, the disease can be asymptomatic for many years. Breath analysis might be helpful to detect occult liver pathology.

Study objective: This study examined whether specific breath odor compounds can be found in liver patients, suffering from cirrhosis, which might be useful for diagnosis.

Materials and methods: Fifty-two liver patients and 50 healthy volunteers were enrolled. Alveolar air was analyzed by gas chromatography-mass spectrometry. Using discriminant analysis a model for liver disease was built.

Results: Dimethyl sulfide, acetone, 2-butanone and 2-pentanone were increased in breath of liver patients, while indole and dimethyl selenide were decreased. Sensitivity and specificity of the model were respectively 100% and 70%.

Conclusions: Fetor hepaticus is caused by dimethyl sulfide and to a lower extent by ketones in alveolar air. Breath analysis by GC-MS makes it possible to discriminate patients with breath malodor related to hepatic pathologies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breath Tests / methods*
  • Case-Control Studies
  • Diabetes Mellitus / metabolism
  • Female
  • Gas Chromatography-Mass Spectrometry / methods*
  • Halitosis / metabolism*
  • Humans
  • Indoles / analysis
  • Ketones / analysis
  • Liver Cirrhosis / metabolism*
  • Male
  • Middle Aged
  • Organoselenium Compounds / analysis
  • Renal Insufficiency / metabolism
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Sulfides / analysis
  • Volatile Organic Compounds / analysis*


  • Indoles
  • Ketones
  • Organoselenium Compounds
  • Sulfides
  • Volatile Organic Compounds
  • indole
  • dimethyl sulfide
  • dimethylselenide