Goto K, Chew F, Torún B, Peerson J M, Brown K H
Department of Nutrition, University of California, Davis 95616-8669, USA.
J Pediatr Gastroenterol Nutr. 1999 Mar;28(3):282-90. doi: 10.1097/00005176-199903000-00013.
Subclinical alterations of small intestinal function have been reported frequently in tropical countries. Studies of small intestinal permeability to lactulose and mannitol were therefore completed in Guatemalan infants from a low-income, periurban community to assess the prevalence of altered intestinal function and the factors associated with this condition.
Two hundred studies were successfully completed in 158 infants who had been free of diarrhea for at least 1 week before the day of study. Urinary concentrations of lactulose and mannitol during the 5-hour period after ingestion of 400 mg/kg body weight of lactulose and 100 mg/kg body weight of mannitol were measured by gas-liquid chromatography and compared by age group, feeding practices, anthropometric indexes, and serum iron and zinc concentrations.
The overall prevalence of altered intestinal permeability (defined as a ratio of urinary recovery of lactulose to mannitol [L/M] > or =0.07) was 30%. The urinary L/M recovery ratio was positively associated with age; low weight for age; and, in infants less than 6 months of age, non-breast-feeding. Children with serum iron concentrations less than 7.16 microM/l (40 [microg/dl) had higher median L/M ratios (L/M = 0.068; 95% confidence interval [CI], 0.054, 0.085) than those with iron levels higher than this cutoff (L/M = 0.052; CI = 0.046, 0.058; p = 0.038). The median urinary L/M recovery ratio in 10 currently asymptomatic infants who had diarrhea during the week before testing (0.087; CI = 0.49, 0.154) was higher than that in children who had been free from diarrhea for at least 1 week (0.052; CI = 0.048, 0.056; p = 0.01).
Age, feeding practices, low weight-for-age, low serum iron concentration, and recent diarrhea were all associated with altered intestinal function in this group of Guatemalan infants.
在热带国家，小肠功能的亚临床改变屡有报道。因此，对危地马拉一个低收入城郊社区的婴儿进行了小肠对乳果糖和甘露醇通透性的研究，以评估肠道功能改变的患病率以及与该状况相关的因素。
在158名婴儿中成功完成了200项研究，这些婴儿在研究当天前至少1周未发生腹泻。通过气液色谱法测量摄入400mg/kg体重乳果糖和100mg/kg体重甘露醇后5小时内尿中乳果糖和甘露醇的浓度，并按年龄组、喂养方式、人体测量指标以及血清铁和锌浓度进行比较。
肠道通透性改变（定义为尿中乳果糖与甘露醇回收率之比[L/M]≥0.07）的总体患病率为30%。尿中L/M回收率与年龄、低年龄别体重呈正相关，对于6个月以下婴儿，还与非母乳喂养有关。血清铁浓度低于7.16μmol/L（40μg/dl）的儿童，其L/M比值中位数（L/M = 0.068；95%置信区间[CI]，0.054，0.085）高于铁水平高于此临界值的儿童（L/M = 0.052；CI = 0.046，0.058；p = 0.038）。在测试前一周有腹泻的10名目前无症状婴儿中，尿中L/M回收率中位数（0.087；CI = 0.49，0.154）高于至少1周未发生腹泻的儿童（0.052；CI = 0.048，0.056；p = 0.01）。
在这组危地马拉婴儿中，年龄、喂养方式、低年龄别体重、低血清铁浓度以及近期腹泻均与肠道功能改变有关。
