Agreement between indirect calorimetry and traditional tests of lactose malabsorption

作者：Alexandre Virginie; Davila Anne Marie^*; Bouchoucha Michel; Bertin Claire; Even Patrick; Lamberto Christine; Tome Daniel; Benamouzig Robert

来源：Digestive and Liver Disease, 2013, 45(9): 727-732.

DOI：10.1016/j.dld.2013.03.015

• Lactose malabsorption
• Respiratory quotient

Background: Lactose malabsorption occurs frequently and the variable consequent intolerance may seriously impair quality of life. No reliable and convenient test method is in routine clinical practice. A recent animal study showed that the respiratory quotient changed significantly after ingestion of sucrose and lactose in naturally lactase-deficient rats.
Aims: This exploratory study evaluated the relevance of monitoring the respiratory quotient after lactose ingestion to detect malabsorption.
Methods: Healthy volunteers were identified and classified lactose absorbers and malabsorbers by a lactose tolerance test (25 g). After an overnight fast, a second lactose challenge was performed to monitor hydrogen excretion and respiratory quotient kinetics over 4 h. Participants also completed questionnaires to score and localise their gastrointestinal symptoms.
Results: 20 subjects were enrolled (10 per group, 60% males, mean age 34 +/- 4 years). Respiratory quotient kinetics were different between absorbers and malabsorbers during the first 100 min after lactose ingestion (p < 0.01) and during the initial 30-50 min period. Respiratory quotient was significantly, positively correlated to peak glycaemia (R = 0.74) and negatively correlated to hydrogen excretion (R = -0.51) and symptoms score (R = -0.46).
Conclusions: Indirect calorimetry could improve the reliability of lactose malabsorption diagnosis. Studies on larger populations are needed to confirm the validity of this test and propose a simplified measurement.

• 出版日期2013-9