Zapata-Castilleja Carlos A, Montes-Tapia Fernando F, Treviño-Garza Consuelo, Martínez-Cobos María C, García-Cantú Jesús, Arenas-Fabbri Vincenzo, de la O-Escamilla Norma, de la O-Cavazos Manuel
Departamento de Pediatría, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, México.
Arch Argent Pediatr. 2017 Apr 1;115(2):148-154. doi: 10.5546/aap.2017.eng.148.
Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance.
A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test.
Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p ≤ 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension.
A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age.
乳糖不耐受是儿科常见疾病，误诊会导致发病。本研究的主要目的是评估氢呼气试验期间腰围增加作为乳糖不耐受预测指标的有效性。次要目的是分析体重指数、腰围测量值和年龄对乳糖不耐受患者腹胀的影响。
共纳入138名3至15岁的受试者。在氢呼气试验期间，他们在3小时内每隔30分钟进行一次腰围和呼气中氢气水平的系列测量。
在整个样本中，35名（25.4%）患者患有乳糖不耐受。与基线腰围相比，腰围增加0.85厘米时，预测乳糖不耐受的敏感性为88%，特异性为85%（比值比：42.14，95%置信区间：13.08 - 135.75，p≤0.001）。体重指数和腰围测量值对腹胀无影响（p=无显著性差异）；然而，年龄会改变腹胀时间。
在氢呼气试验期间，与基线腰围相比腰围增加0.85厘米是儿科诊断乳糖不耐受的一个有用参数。与体重指数和腰围的变化不同，年龄并未影响腰围增加这一指标的有效性。
