印度尼西亚儿童的乳糖不耐受症

Lactose intolerance in Indonesian children.

作者信息

Hegar Badriul, Widodo Ariani

机构信息

Department of Child Health, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Email:

Department of Child Health, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

出版信息

Asia Pac J Clin Nutr. 2015;24 Suppl 1:S31-40. doi: 10.6133/apjcn.2015.24.s1.06.

Abstract

"Lactose intolerance (LI)" is considered a common problem in Asians, and in many parts of the world. Its prevalence and age of manifestation varies between by Asian country, for possible genetic or cultural reasons. Studies in Indonesian children 3-15 years old (y) are available within the past two decades, using a pure lactose tolerance test. The prevalences of lactose malabsorption (LM) in pre-elementary (3-5 y), elementary (6-11 y), and junior high (12-14 y) school-children were 21.3%, 57.8%, and 73%, respectively. An increasing trend for LM prevalence was seen within the pre-elementary group, from 9.1% at 3 y to 28.6% at 5 y. The most frequent symptoms of LI in junior high school (JHS) group were abdominal pain (64.1%), abdominal distention (22.6%), nausea (15.1%), flatulence (5.7%), and diarrhea (1.9%), mostly within one hour of lactose ingestion. In children with regular and irregular milk drinking, LM occurred in 81.2% and 69.6%; LI was found in 56.2% and 52.1%, respectively. Most JHS children with dairy-associated recurrent abdominal pain (RAP) symptoms proved to be malabsorbers. Dairy products most related to RAP were milk and yogurt. LI was found in 81% of RAP children with abdominal pain most frequently, followed by nausea, bloating, diarrhea, borborygmi, and flatulence. Symp-tom onset occurred 30 minutes after lactose ingestion, especially nausea, bloating, and abdominal pain. In RAP children LI symptoms mostly found in breath hydrogen concentration>20 ppm. More LI symptoms were found in lactose malabsorbers, but symptoms were mild and generally disappeared in 7 hours, and in most by 15 hours.

摘要

乳糖不耐受(LI)在亚洲人和世界许多地区被认为是一个常见问题。由于可能的遗传或文化原因,其患病率和发病年龄因亚洲国家而异。在过去二十年中,有针对印度尼西亚3至15岁儿童进行的研究,采用了纯乳糖耐量试验。学前儿童(3至5岁)、小学生(6至11岁)和初中生(12至14岁)中乳糖吸收不良(LM)的患病率分别为21.3%、57.8%和73%。在学前儿童组中,LM患病率呈上升趋势,从3岁时的9.1%升至5岁时的28.6%。初中生组中LI最常见的症状是腹痛(64.1%)、腹胀(22.6%)、恶心(15.1%)、肠胃胀气(5.7%)和腹泻(1.9%),大多在摄入乳糖后一小时内出现。在经常和不经常饮用牛奶的儿童中,LM的发生率分别为81.2%和69.6%;LI的发生率分别为56.2%和52.1%。大多数有与乳制品相关的复发性腹痛(RAP)症状的初中生被证明是吸收不良者。与RAP最相关的乳制品是牛奶和酸奶。在有腹痛的RAP儿童中,81%发现有LI,其次是恶心、腹胀、腹泻、肠鸣和肠胃胀气。症状在摄入乳糖后30分钟出现,尤其是恶心、腹胀和腹痛。在RAP儿童中,LI症状大多出现在呼气氢浓度>20 ppm时。乳糖吸收不良者中发现更多的LI症状,但症状较轻,一般在7小时内消失,大多数在15小时内消失。

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