Asfari Mohammad Maysara, Hamid Osama, Sarmini Muhammad Talal, Kendrick Katherine, Pappoppula Lakshmi Priyanka, Sifuentes Humberto, Sridhar Subbaramiah
Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, USA.
Department of Hospital Medicine, Cleveland Clinic, Cleveland, USA.
Cureus. 2022 May 3;14(5):e24713. doi: 10.7759/cureus.24713. eCollection 2022 May.
Lactose intolerance (LI) appears usually in later ages when the lactase enzyme becomes deficient or absent in the small intestine. Conflicting results have been reported in the literature about the association of lactose intolerance with various gastrointestinal malignancies. Hence, our aim was to study the association between LI, colon cancer (CCa), and gastric cancer (GC) using a large database.
A cross-sectional study was performed using the National Inpatient Sample (NIS) database between 2004 and 2014. We identified adult patients (18-90 years) who were diagnosed with LI (study group) using appropriate International Classification of Diseases, Ninth Revision (ICD-9) codes. The control group comprised patients who did not have a diagnosis of LI. We identified the diagnosis of CCa and GC in both study and control groups using the ICD-9 codes. Univariable and multivariable logistic regression analyses were performed to assess the association between LI, CCa, and GC.
The total population comprised 71,360,501 patients, of which 57,909 (0.08%) were diagnosed with LI. LI patients were older (62 vs 51 years) with more females (61.5% vs 60.1%) and less African American patients (11.8% vs 14.3%) (p <0.0001 for all). In addition, LI patients had more smoking (12.4% vs 12%) and obesity (15% vs 8.9%). On the other hand, patients in the LI group had less alcohol use (3.8% vs 4.2%) (p <0.0001). After adjusting for the age, gender, race, smoking, alcohol, obesity, and inflammatory bowel disease, the LI group had a slightly lower rate of CCa (OR 0 .974, 95%CI 0.906-1.048, p = 0.486) and a lower rate of GC (OR: 0.993, 95%CI 0.924-1.068, p =0.853); however, the results were not statistically significant.
Patients with lactose intolerance may have a lower risk of colon and gastric cancer. However, these findings were not statistically significant. Further studies are needed to understand this association.
乳糖不耐受（LI）通常出现在晚年，此时小肠中的乳糖酶缺乏或缺失。关于乳糖不耐受与各种胃肠道恶性肿瘤之间的关联，文献报道的结果相互矛盾。因此，我们的目的是使用一个大型数据库研究乳糖不耐受、结肠癌（CCa）和胃癌（GC）之间的关联。
利用2004年至2014年的国家住院样本（NIS）数据库进行了一项横断面研究。我们使用适当的国际疾病分类第九版（ICD-9）编码，确定了被诊断为乳糖不耐受的成年患者（18-90岁）（研究组）。对照组包括未被诊断为乳糖不耐受的患者。我们使用ICD-9编码在研究组和对照组中确定CCa和GC的诊断。进行单变量和多变量逻辑回归分析，以评估LI、CCa和GC之间的关联。
总共有71360501名患者，其中57909名（0.08%）被诊断为乳糖不耐受。乳糖不耐受患者年龄较大（62岁对51岁），女性更多（61.5%对60.1%），非裔美国患者更少（11.8%对14.3%）（所有p<0.0001）。此外，乳糖不耐受患者吸烟更多（12.4%对12%），肥胖更多（15%对8.9%）。另一方面，乳糖不耐受组患者饮酒较少（3.8%对4.2%）（p<0.0001）。在调整年龄、性别、种族、吸烟、饮酒、肥胖和炎症性肠病后，乳糖不耐受组的CCa发病率略低（OR 0.974，95%CI 0.906-1.048，p=0.486），GC发病率较低（OR：0.993，95%CI 0.924-1.068，p=0.853）；然而，结果没有统计学意义。
乳糖不耐受患者患结肠癌和胃癌的风险可能较低。然而，这些发现没有统计学意义。需要进一步研究以了解这种关联。
