Goodwin Annie, Karam Lina, Gopalakrishna G S, Kellermayer Richard
Section of Pediatric Gastroenterology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
USDA/ARS Children's Nutrition Research Center, Houston, TX, USA.
J Mol Biochem. 2018;7(1):41-47. Epub 2018 May 31.
Lactase deficiency can lead to significant symptoms in the pediatric population. To date, few studies have examined the prevalence of enzyme testing-based lactase and other disaccharidase deficiencies (DDs) in pediatric patients undergoing upper endoscopic evaluation. The primary objective of this study was to determine the prevalence of selective lactase and other DDs amongst a large cohort of pediatric patients with and without inflammatory bowel disease (IBD: Crohn's disease and ulcerative colitis) via a chart review of 739 patients who underwent esophago-gastro-dudenoscopy EGD between April 2010 and August 2016. We identified 560 pediatric patients (ages 1-18 years) who underwent mucosal enzyme testing at the time of their EGD. The overall rate of lactase deficiency (LD) was 39%. LD positively correlated with age (p=0.00017), but there was no significant difference between age matched IBD and non-IBD patients (45% vs. 42% p=0.68). Four patients (0.17%) were found to have selective maltase deficiency. No selective sucrase or palatinase deficiency was identified. Statistically significant differences occurred in lactase deficiency amongst patients of different races. In conclusion, lactase deficiency is a relatively common finding in children undergoing EGD though at no increased rate amongst the IBD patient population. Disaccharidase testing should be considered in pediatric patients undergoing EGD.
乳糖酶缺乏可导致儿科人群出现明显症状。迄今为止，很少有研究调查接受上消化道内镜检查的儿科患者中基于酶检测的乳糖酶及其他双糖酶缺乏症（DDs）的患病率。本研究的主要目的是通过回顾2010年4月至2016年8月期间接受食管-胃-十二指肠镜检查（EGD）的739例患者的病历，确定一大群患有和未患有炎症性肠病（IBD：克罗恩病和溃疡性结肠炎）的儿科患者中选择性乳糖酶缺乏及其他DDs的患病率。我们确定了560例在EGD检查时接受黏膜酶检测的儿科患者（年龄1 - 18岁）。乳糖酶缺乏（LD）的总体发生率为39%。LD与年龄呈正相关（p = 0.00017），但年龄匹配的IBD患者和非IBD患者之间无显著差异（45%对42%，p = 0.68）。发现4例患者（0.17%）患有选择性麦芽糖酶缺乏症。未发现选择性蔗糖酶或帕拉金酶缺乏症。不同种族患者的乳糖酶缺乏存在统计学显著差异。总之，乳糖酶缺乏在接受EGD检查的儿童中是相对常见的发现，尽管在IBD患者群体中发生率并未增加。对于接受EGD检查的儿科患者，应考虑进行双糖酶检测。
