Cell Biology of Disease Research Group and PERI Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
J Pediatr Gastroenterol Nutr. 2011 May;52(5):581-4. doi: 10.1097/MPG.0b013e3181fd1315.
Fructose malabsorption can produce symptoms such as chronic diarrhoea and abdominal pain. Here, we retrospectively review breath hydrogen test (BHT) results to determine whether age has an effect on the clinical application of the fructose BHT and compare this with the lactose BHT.
Patients were referred to a gastroenterology breath-testing clinic (2003-2008) to investigate carbohydrate malabsorption as a cause of gastrointestinal symptoms. Patients received either 0.5 g/kg body weight of fructose (maximum of 10 g) or 2 g/kg of lactose (maximum of 20 g), in water, and were tested for 2.5 hours.
Patient age showed a significant effect on the fructose BHT results (P < 0.001, 0.1-79 years old, n = 1093). The odds of testing positive for fructose malabsorption in paediatric patients (15 years old or younger, n = 760) decreased by a factor of 0.82/year (95% confidence interval 0.79-0.86, P < 0.001). There were 88.2% positive in younger than 1-year-olds, 66.6% in 1- to 5-year-olds, 40.4% in 6- to 10-year-olds, and 27.1% in 10- to 15-year-olds. In contrast, 39.3% of lactose BHTs were positive, with no significant relation between patient age and test result (P = 0.115, 0.1-89 years old, n = 3073).
The majority of infants with gastrointestinal symptoms exhibited fructose malabsorption, but the capacity to absorb fructose increased with patient age up to 10 years old. The low threshold for fructose absorption in younger children has significant implications for the performance and interpretation of the fructose BHT and for the dietary consumption of fructose in infants with gastrointestinal symptoms.
果糖吸收不良可引起慢性腹泻和腹痛等症状。在此，我们回顾性分析氢呼气试验（BHT）结果，以确定年龄是否对果糖 BHT 的临床应用有影响，并与乳糖 BHT 进行比较。
患者因胃肠道症状被转至胃肠病学呼气检测诊所（2003-2008 年）以调查碳水化合物吸收不良的原因。患者口服 0.5 g/kg 体重的果糖（最大剂量为 10 g）或 2 g/kg 的乳糖（最大剂量为 20 g），溶于水中，检测 2.5 小时。
患者年龄对果糖 BHT 结果有显著影响（P<0.001，0.1-79 岁，n=1093）。儿童患者（15 岁或以下，n=760）检测出果糖吸收不良的阳性率随年龄增加而降低，每年降低 0.82（95%置信区间 0.79-0.86，P<0.001）。1 岁以下患者阳性率为 88.2%，1-5 岁为 66.6%，6-10 岁为 40.4%，10-15 岁为 27.1%。相比之下，39.3%的乳糖 BHT 阳性，患者年龄与检测结果之间无显著关系（P=0.115，0.1-89 岁，n=3073）。
大多数有胃肠道症状的婴儿存在果糖吸收不良，但随着年龄增长，果糖吸收能力逐渐增强，至 10 岁左右达到成人水平。儿童对果糖的低吸收阈值对果糖 BHT 的性能和解释以及有胃肠道症状的婴儿果糖的饮食摄入有重要影响。
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