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Lactose (mal)digestion evaluated by the 13 C‐lactose digestion test
Author(s) -
Rj Vonk,
Yuguang Lin,
H. A. Koetse,
Huang Cy,
Guo Zeng,
Harmke Elzinga,
Jean Michel Antoine,
Frans Stellaard
Publication year - 2000
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.2000.00609.x
Subject(s) - lactose , breath test , lactase , digestion (alchemy) , population , medicine , chemistry , area under the curve , lactose intolerance , food science , endocrinology , zoology , gastroenterology , biology , chromatography , environmental health , helicobacter pylori
Background The prevalence of genetically determined lactase nonpersistence is based on the results of the lactose H 2 breath test. This test, however, is an indirect test, which might lead to misinterpretation. Design We determined lactase activity in healthy Chinese and Dutch students using a novel 13 C‐lactose digestion test. The cut‐off value of this test was established in a Chinese population with a homogenous genetic background of lactase nonpersistence and was compared with the results obtained in a Caucasian population. Twenty‐five grams of a 13 C‐lactose solution was consumed by 12 known H 2 ‐positive and 5 H 2 ‐negative Chinese students and 48 Dutch students and, subsequently, 13 C‐glucose concentration in plasma and H 2 excretion in breath were measured. Results A similar 13 C‐glucose response curve was found in all Chinese students. The mean response curve in the Dutch students was more pronounced ( P < 0.01). The 1 h (peak) plasma 13 C‐glucose concentration was the best discriminator between lactose digesting and maldigesting subjects. The cut‐off level of 2 mmol L −1 13 C‐glucose in plasma was defined in the H 2 ‐positive Chinese students group. Based on the 13 C‐glucose response the prevalence of lactose maldigestion in the Dutch subjects was 25%; based on the lactose H 2 breath test 17%. Conclusions Using the 13 C‐lactose digestion test the results demonstrate a higher prevalence of lactose maldigestion in a Caucasian population than indicated by the results of the H 2 breath test. A moderate increase in the plasma 13 C‐glucose concentration after consumption of 13 C‐lactose in the young adult Chinese subjects indicates a residual lactase activity in that age group, even when a positive H 2 breath test result is obtained. These results indicate that the 13 C‐glucose concentration in plasma more accurately reflects the small intestinal lactose digestion capacity than the lactose H 2 breath test.