Functional Significance of Single Nucleotide Polymorphisms in the Lactase Gene in Diverse US Patients and Evidence for a Novel Lactase Persistence Allele at −13909 in Those of European Ancestry

Objectives: Recent data from mainly homogeneous European and African populations implicate a 140‐bp region 5′ to the transcriptional start site of LCT (the lactase gene) as a regulatory site for lactase persistence and nonpersistence. Because there are no studies of US nonhomogeneous populations, we performed genotype/phenotype analysis of the −13910 and −22018 LCT single nucleotide polymorphisms (SNPs) in New England children, mostly of European ancestry. Methods: Duodenal biopsies were processed for disaccharidase activities, RNA quantification by reverse transcription polymerase chain reaction (RT‐PCR), allelic expression ratios by PCR, and genotyping and SNP analysis. Results were compared with clinical information. Results: Lactase activity and mRNA levels, and sucrase‐to‐lactase ratios of enzyme activity and mRNA, showed robust correlations with genotype. None of the other LCT SNPs showed as strong a correlation with enzyme or mRNA levels as did −13910. Data were consistent, with the −13910 being the causal sequence variant instead of −22018. Four individuals heterozygous for −13910T/C had allelic expression patterns similar to individuals with −13910C/C genotypes; of these, 2 showed equal LCT expression from the 2 alleles and a novel variant (−13909C>A) associated with lactase persistence. Conclusions: The identification of −13910C/C genotype is likely to predict lactase nonpersistence, consistent with prior published studies. A −13910T/T genotype will frequently, but not perfectly, predict lactase persistence in this mixed European‐ancestry population; a −13910T/C genotype will not predict the phenotype. A long, rare haplotype in 2 individuals with −13910T/C genotype but equal allele‐specific expression contains a novel lactase persistence allele present at −13909.