贫民窟儿童甲烷生成与小肠细菌过度生长。
Methane production and small intestinal bacterial overgrowth in children living in a slum.
机构信息
Pediatric Gastroenterology Division, Federal University of Sao Paulo, 04039-031 Sao Paulo, Brazil.
出版信息
World J Gastroenterol. 2012 Nov 7;18(41):5932-9. doi: 10.3748/wjg.v18.i41.5932.
AIM
To analyze small intestinal bacterial overgrowth in school-aged children and the relationship between hydrogen and methane production in breath tests.
METHODS
This transversal study included 85 children residing in a slum and 43 children from a private school, all aged between 6 and 10 years, in Osasco, Brazil. For characterization of the groups, data regarding the socioeconomic status and basic housing sanitary conditions were collected. Anthropometric data was obtained in children from both groups. All children completed the hydrogen (H(2)) and methane (CH(4)) breath test in order to assess small intestinal bacterial overgrowth (SIBO). SIBO was diagnosed when there was an increase in H(2) ≥ 20 ppm or CH(4) ≥ 10 ppm with regard to the fasting value until 60 min after lactulose ingestion.
RESULTS
Children from the slum group had worse living conditions and lower nutritional indices than children from the private school. SIBO was found in 30.9% (26/84) of the children from the slum group and in 2.4% (1/41) from the private school group (P = 0.0007). Greater hydrogen production in the small intestine was observed in children from the slum group when compared to children from the private school (P = 0.007). A higher concentration of hydrogen in the small intestine (P < 0.001) and in the colon (P < 0.001) was observed among the children from the slum group with SIBO when compared to children from the slum group without SIBO. Methane production was observed in 63.1% (53/84) of the children from the slum group and in 19.5% (8/41) of the children from the private school group (P < 0.0001). Methane production was observed in 38/58 (65.5%) of the children without SIBO and in 15/26 (57.7%) of the children with SIBO from the slum. Colonic production of hydrogen was lower in methane-producing children (P = 0.017).
CONCLUSION
Children who live in inadequate environmental conditions are at risk of bacterial overgrowth and methane production. Hydrogen is a substrate for methane production in the colon.
目的
分析学龄儿童小肠细菌过度生长与氢和甲烷呼气试验之间的关系。
方法
本横断面研究纳入了巴西奥萨斯科市贫民窟 85 名 6 至 10 岁儿童和私立学校 43 名儿童。为了对两组进行特征描述，收集了社会经济地位和基本住房卫生条件的数据。对两组儿童进行了人体测量学数据的获取。所有儿童均完成了氢（H2）和甲烷（CH4）呼气试验，以评估小肠细菌过度生长（SIBO）。当摄入乳果糖后 60 分钟内 H2 增加≥20 ppm 或 CH4 增加≥10 ppm 时，诊断为 SIBO。
结果
贫民窟组儿童的生活条件较差，营养指数低于私立学校儿童。贫民窟组中 30.9%（26/84）的儿童和私立学校组中 2.4%（1/41）的儿童存在 SIBO（P=0.0007）。与私立学校儿童相比，贫民窟组儿童的小肠产氢量更大（P=0.007）。与贫民窟组无 SIBO 儿童相比，贫民窟组 SIBO 儿童的小肠（P<0.001）和结肠（P<0.001）中氢浓度更高。贫民窟组 63.1%（53/84）的儿童和私立学校组 19.5%（8/41）的儿童存在甲烷生成（P<0.0001）。在无 SIBO 的 58 名儿童中，有 38 名（65.5%）存在甲烷生成，在有 SIBO 的 26 名儿童中，有 15 名（57.7%）存在甲烷生成。产甲烷儿童结肠产氢量较低（P=0.017）。
结论
生活在环境条件差的儿童易发生细菌过度生长和甲烷生成。氢是结肠甲烷生成的底物。
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