Can J Gastroenterol Hepatol. 2015 Apr;29(3):149-56. doi: 10.1155/2015/904686.
Adult assimilation of lactose divides humans into dominant lactase-persistent and recessive nonpersistent phenotypes.
To review three medical parameters of lactose digestion, namely: the changing concept of lactose intolerance; the possible impact on diseases of microbial adaptation in lactase-nonpersistent populations; and the possibility that the evolution of lactase has influenced some disease pattern distributions.
A PubMed, Google Scholar and manual review of articles were used to provide a narrative review of the topic.
The concept of lactose intolerance is changing and merging with food intolerances. Microbial adaptation to regular lactose consumption in lactase-nonpersistent individuals is supported by limited evidence. There is evidence suggestive of a relationship among geographical distributions of latitude, sunhine exposure and lactase proportional distributions worldwide.
The definition of lactose intolerance has shifted away from association with lactose maldigestion. Lactose sensitivity is described equally in lactose digesters and maldigesters. The important medical consequence of withholding dairy foods could have a detrimental impact on several diseases; in addition, microbial adaptation in lactase-nonpersistent populations may alter risk for some diseases. There is suggestive evidence that the emergence of lactase persistence, together with human migrations before and after the emergence of lactase persistence, have impacted modern-day diseases.
Lactose maldigestion and lactose intolerance are not synonymous. Withholding dairy foods is a poor method to treat lactose intolerance. Further epidemiological work could shed light on the possible effects of microbial adaptation in lactose maldigesters. The evolutionary impact of lactase may be still ongoing.
成人乳糖吸收能力可将人类分为显性乳糖持续型和隐性乳糖非持续型表型。
综述乳糖消化的三个医学参数，即乳糖不耐受概念的变化；乳糖酶非持续人群中微生物适应可能对疾病的影响；以及乳糖酶进化是否可能影响某些疾病模式分布的可能性。
通过 PubMed、Google Scholar 和对文章的手动综述，提供对该主题的叙述性综述。
乳糖不耐受的概念正在发生变化，并与食物不耐受相融合。有限的证据支持乳糖酶非持续个体中对常规乳糖摄入的微生物适应。有证据表明，纬度、阳光暴露和全球乳糖酶比例分布的地理分布之间存在关联。
乳糖不耐受的定义已从与乳糖消化不良相关的定义转移。乳糖消化和消化不良的人同样被描述为乳糖敏感。拒绝食用乳制品可能对几种疾病产生不利影响；此外，乳糖酶非持续人群中的微生物适应可能会改变某些疾病的风险。有证据表明，乳糖酶持续存在的出现，以及乳糖酶持续存在前后人类的迁徙，对现代疾病产生了影响。
乳糖消化不良和乳糖不耐受不是同义词。拒绝食用乳制品是治疗乳糖不耐受的一种不良方法。进一步的流行病学研究可能有助于了解乳糖消化不良者中微生物适应的可能影响。乳糖酶的进化影响可能仍在继续。
