Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis

Storhaug, Christian Løvold; Fosse, Svein Kjetil; Fadnes, Lars Thore

doi:10.1016/s2468-1253(17)30154-1

Cited by 323 publications

(190 citation statements)

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“…[49]. We also correlated obesity and reported LNP frequencies based on data from Storhaug [44] and some from Itan [45] and Szilagyi [49] (Table 2). It is noted that in both sets of obesity data there is a weak relationship with latitude or sunshine but a modest correlation with LNP.…”

Section: Latitude Sunshine Vitamin D and Obesitymentioning

confidence: 96%

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Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

Szilagyi

2019

Clin J Gastroenterol

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The inflammatory bowel diseases, Crohn's and ulcerative colitis have increased in incidence and prevalence from the mideighteen to the late nineteen centuries. From then to the current twenty-first century there has been a more rapid expansion of these disease to areas previously experiencing low rates. This latter expansion coincides with the current obesity pandemic which also began toward the end of the last century. Although the two diseases have radically different frequencies, there are interesting links between them. Four areas link the diseases. On an epidemiological level, IBD tends to follow a northsouth gradient raising the importance of vitamin D in protection. Obesity has very weak relationship with latitude, but both diseases follow adult lactase distributions colliding in this plane. Is it possible that obesity (a low vitamin D condition with questionable response to supplements) reduces effects in IBD? On a pathogenic level, pro-inflammatory processes mark both IBD and obesity. The similarity raises the question of whether obesity could facilitate the development of IBD. Features of the metabolic syndrome occur in both, with or without obesity in IBD. The fourth interaction between the two diseases is the apparent effect of obesity on the course of IBD. There are suggestions that obesity may reduce the efficacy of biologic agents. Yet there is some suggestion also that obesity may reduce the need for hospitalization and surgery. The apparent co-expansion of both obesity and IBD suggests similar environmental changes may be involved in the promotion of both.

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Section: Latitude Sunshine Vitamin D and Obesitymentioning

confidence: 96%

“…When obesity is examined in relation with latitude there is an apparent global lack of association [44][45][46]. Hossain et al plotted diabetes frequency by global regions (which closely follow the prevalence of obesity) based on data from 2000.…”

Section: Latitude Sunshine Vitamin D and Obesitymentioning

confidence: 99%

Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

Szilagyi

2019

Clin J Gastroenterol

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“…LM can be diagnosed through different ways, the non‐invasive and inexpensive LBT and LTT being the most common methods. The sensitivity and specificity of these tests depends on the lactose dose, but they are relatively high (78% and 93%) . Before (baseline) and after the ingestion of a given amount of lactose, breath and blood samples are collected at different time points for a period of time and end‐alveolar H 2 and blood glucose concentrations are measured.…”

Section: Methodsmentioning

confidence: 99%

“…The sensitivity and specificity of these tests depends on the lactose dose, but they are relatively high (78% and 93%). 32 Before (baseline) and after the ingestion of a given amount of lactose, breath and blood samples are collected at different time points for a period of time and end-alveolar H 2 and blood glucose concentrations are measured. A certain rise of H 2 (or additionally methane) and/or no rise of blood glucose (or additionally galactose) above the baseline levels are considered diagnostic for lactose maldigestion.…”

Section: Outcome Measurementioning

confidence: 99%

Lactose intolerance but not lactose maldigestion is more frequent in patients with irritable bowel syndrome than in healthy controls: A meta‐analysis

Varjú

Gede

Szakács

et al. 2018

Neurogastroenterology Motil

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Background and Purpose Irritable bowel syndrome (IBS) affects 10%‐20% of the adult population and is characterized by abdominal symptoms without relevant organic disease. There are numerous clinical trials available investigating the relationship between IBS, lactose maldigestion (LM), and lactose intolerance (LI), but there have been no meta‐analyses on this topic yet. We aimed to assess the prevalence of LM, objective and subjective (self‐reported) LI in IBS patients compared to healthy controls (HC) without IBS. Methods A systematic literature search was conducted up to 24 April 2018 in PubMed, Embase, and Cochrane Library. Adult IBS patients had to be diagnosed according to the Rome criteria or other well‐defined criteria system. We enrolled controlled studies including healthy adult participants without IBS, as control group. Odds ratios with 95% confidence intervals were calculated. Key Results Altogether 14 articles were suitable for statistical analyses. IBS patients reported themselves significantly more frequently lactose intolerant than HCs (odds ratio [OR] = 3.499; 95% confidence interval [CI] = 1.622‐7.551). Generally, there was no significant difference in the prevalence of LM based on ingested lactose dose (OR = 1.122; 95% CI = 0.929‐1.356) and test type (OR = 1.156; 95% CI = 0.985‐1.356). However, significantly more IBS patients had objective LI (OR = 2.521; 95% CI = 1.280‐4.965). Conclusions and Inferences Lactose intolerance, but not LM is more frequent among patients with IBS compared to HCs. According to our results, IBS among other functional bowel disorders is a possible contributing factor of LI in people with LM.

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“…La actividad de la lactasa es máxima durante la infancia y en el adulto permanece elevada solo en aquellos con fenotipo lactasa persistente. La lactosa no absorbida es fermentada por la microflora bacteriana del colón, produciendo ácidos grasos de cadena corta y gases como hidrógeno, metano y dióxido de carbono (2) . Estas sustancias provocan diferentes síntomas como dolor abdominal, diarrea, flatos, distensión abdominal, eructos y meteorismo.…”

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Malabsorción de lactosa en adolescentes de un club de fútbol

Accinelli¹,

Herrera²,

Canales³

et al. 2017

Rev Peru Med Exp Salud Publica

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Sr Editor. La malabsorción de lactosa (MAL) se produce por ausencia o disminución de la actividad de la enzima lactasa (1) . La actividad de la lactasa es máxima durante la infancia y en el adulto permanece elevada solo en aquellos con fenotipo lactasa persistente. La lactosa no absorbida es fermentada por la microflora bacteriana del colón, produciendo ácidos grasos de cadena corta y gases como hidrógeno, metano y dióxido de carbono (2) . Estas sustancias provocan diferentes síntomas como dolor abdominal, diarrea, flatos, distensión abdominal, eructos y meteorismo.La intolerancia a la lactosa (IL) es la aparición de estos síntomas luego de ingerir 12 g de lactosa, cantidad presente en 240 mL de leche. El umbral de tolerancia/intolerancia depende no solo de la actividad de la enzima lactasa sino, además de la dosis de lactosa, el vaciamiento gástrico, el tiempo de tránsito intestinal y el tipo y cantidad de flora bacteriana intestinal (1) .Realizamos un estudio para determinar la frecuencia de MAL en un grupo de adolescentes jugadores de fútbol. Para ello, se tomó una muestra no probabilística de 98 futbolistas amateurs del Club Cantolao (Lima-Perú), todos de sexo masculino, a quienes se le realizó la prueba de tolerancia a la lactosa, que tiene una especificidad de 77-96% y sensibilidad de 76-94% (3) . La prueba consistió en tomar muestras de sangre venosa en cuatro ocasiones, primero se midió la glicemia basal, luego se dio a cada participante una dosis estándar de lactosa (2 g/kg hasta un máximo de 50 g) y posterior a la ingesta de esta se tomaron glicemias a los 30, 60 y 120 min (4) . Se consideró un aumento de glucosa en sangre menor o igual a 20 g/dL para el diagnóstico de MAL.La prueba de tolerancia a la lactosa fue positiva en 54 participantes, con lo que se obtuvo una frecuencia de MAL de 55,1%. Otros autores peruanos muestran que la MAL se presenta en más del 50% de personas estudiadas (Tabla 1).En América Latina las prevalencias no distan mucho de este resultado, países como Chile, Colombia y Ecuador presentan MAL en 51%, 59% y 65% respectivamente, mientras que en Bolivia la prevalencia es mayor (85%). En el sur de Europa (70-80%), entre nativos americanos (80-95%) y en el sur de Asia (90%) se presentan las prevalencias más elevadas, mientras que en el norte de Europa se encuentra una menor prevalencia (menor de 5%). Estas diferencias a nivel mundial pueden ser explicadas en función de la carga genética, las prácticas culturales y los mecanismos evolutivos a los que han estado expuestos.El momento del inicio de consumo de leche en la dieta de la población adulta también parece explicar estas diferencias. En Europa se inició aproximadamente hace 7500 años y por selección positiva apareció la persistencia de la lactasa hace 5000 años. En cambio, el consumo de productos lácteos en la edad adulta en América Latina ocurrió hace menos de 500 años cuando llegaron los europeos.Existen diferentes métodos para diagnosticar malabsorción a lactosa. Las pruebas de actividad de lactasa en biopsias de mucosa del ...

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Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis

Abstract: None.

Cited by 323 publications

References 53 publications

Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

Lactose intolerance but not lactose maldigestion is more frequent in patients with irritable bowel syndrome than in healthy controls: A meta‐analysis

Malabsorción de lactosa en adolescentes de un club de fútbol

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