乳糖吸收不良及相关疑似疾病：当前证据综述。
Lactose Malabsorption and Presumed Related Disorders: A Review of Current Evidence.
机构信息
Gastroenterology Unit, Brotzu Hospital, 09121 Cagliari, Italy.
Gastroenterology Unit, University of Cagliari, 09042 Monserrato, Italy.
出版信息
Nutrients. 2022 Jan 28;14(3):584. doi: 10.3390/nu14030584.
BACKGROUND
Lactose malabsorption (LM) is a frequent clinical problem associated with several digestive and extra-digestive diseases. The aim of this manuscript was to clarify the real clinical impact of LM on these disorders.
METHODS
A literature search for digestive and extra-digestive disorders related to LM was carried out using PubMed, Medline and Cochrane.
RESULTS
A transient lactase deficiency is present in celiac disease (CD) on a normal diet. The persistence of symptoms in CD on a gluten-free diet may be instead, in part, attributed to a primary LM. Similar circumstances are present in inflammatory bowel diseases (IBD), in which LM can be responsible for a part of persistent symptoms in IBD on clinical remission. LM and irritable bowel syndrome (IBS) are instead independent conditions. On the other hand, a lactose-restricted diet may be useful for some IBS patients. A reduced lactose intake can lead to low bone mass and limited risk of fragility fractures. Finally, the absorption of levothyroxine could be conditioned by LM.
CONCLUSIONS
LM can be responsible for persistent symptoms in CD and IBD. The association with IBS seems to be casual. Bone mass and levothyroxine absorption can be affected by LM.
背景
乳糖吸收不良（LM）是与多种消化和非消化疾病相关的常见临床问题。本文的目的是阐明 LM 对这些疾病的实际临床影响。
方法
使用 PubMed、Medline 和 Cochrane 对与 LM 相关的消化和非消化疾病进行了文献检索。
结果
在正常饮食下，乳糜泻（CD）患者存在短暂的乳糖酶缺乏。在无麸质饮食下，CD 患者的症状持续存在，部分原因可能是原发性 LM。在炎症性肠病（IBD）中也存在类似的情况，在 IBD 临床缓解时，LM 可能导致部分患者持续存在症状。LM 和肠易激综合征（IBS）则是独立的病症。另一方面，对于一些 IBS 患者，限制乳糖的饮食可能是有用的。减少乳糖的摄入可能会导致低骨量和骨折脆性的风险有限。最后，LM 可能会影响左甲状腺素的吸收。
结论
LM 可导致 CD 和 IBD 患者的症状持续存在。与 IBS 的关联似乎是偶然的。LM 会影响骨量和左甲状腺素的吸收。
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