Houben Els, De Preter Vicky, Billen Jaak, Van Ranst Marc, Verbeke Kristin
Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven 3000, Belgium.
Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven 3000, Belgium.
Nutrients. 2015 Sep 7;7(9):7469-85. doi: 10.3390/nu7095348.
The lactose hydrogen breath test is a commonly used, non-invasive method for the detection of lactose malabsorption and is based on an abnormal increase in breath hydrogen (H₂) excretion after an oral dose of lactose. We use a combined (13)C/H₂ lactose breath test that measures breath (13)CO₂ as a measure of lactose digestion in addition to H₂ and that has a better sensitivity and specificity than the standard test. The present retrospective study evaluated the results of 1051 (13)C/H₂ lactose breath tests to assess the impact on the diagnostic accuracy of measuring breath CH₄ in addition to H₂ and (13)CO₂. Based on the (13)C/H₂ breath test, 314 patients were diagnosed with lactase deficiency, 138 with lactose malabsorption or small bowel bacterial overgrowth (SIBO), and 599 with normal lactose digestion. Additional measurement of CH₄ further improved the accuracy of the test as 16% subjects with normal lactose digestion and no H₂-excretion were found to excrete CH₄. These subjects should have been classified as subjects with lactose malabsorption or SIBO. In conclusion, measuring CH₄-concentrations has an added value to the (13)C/H₂ breath test to identify methanogenic subjects with lactose malabsorption or SIBO.
乳糖氢呼气试验是一种常用的、用于检测乳糖吸收不良的非侵入性方法，其基于口服乳糖后呼气中氢气（H₂）排泄异常增加。我们使用一种联合的（¹³）C/H₂乳糖呼气试验，该试验除了测量H₂外，还测量呼气中的（¹³）CO₂作为乳糖消化的指标，并且比标准试验具有更好的敏感性和特异性。本回顾性研究评估了1051次（¹³）C/H₂乳糖呼气试验的结果，以评估除H₂和（¹³）CO₂外测量呼气中CH₄对诊断准确性的影响。基于（¹³）C/H₂呼气试验，314例患者被诊断为乳糖酶缺乏，138例为乳糖吸收不良或小肠细菌过度生长（SIBO），599例乳糖消化正常。CH₄的额外测量进一步提高了试验的准确性，因为发现16%乳糖消化正常且无H₂排泄的受试者会排泄CH₄。这些受试者应被归类为乳糖吸收不良或SIBO受试者。总之，测量CH₄浓度对（¹³）C/H₂呼气试验有附加价值，可用于识别产甲烷的乳糖吸收不良或SIBO受试者。
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