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肠易激综合征患者中成人型乳糖酶缺乏症的发病率。

The incidence of adult type hypolactasia in patients with irritable bowel syndrome.

作者信息

Domżał-Magrowska Danuta, Kowalski Marek K, Małecka-Wojciesko Ewa

机构信息

Department of Digestive Tract Diseases, Norbert Barlicki Memorial University Hospital, Lodz, Poland.

出版信息

Prz Gastroenterol. 2023;18(1):110-114. doi: 10.5114/pg.2023.126043. Epub 2023 Mar 24.

Abstract

INTRODUCTION

The incidence of lactose intolerance in irritable bowel syndrome (IBS) varies in the literature (27-72%). Primary adult lactase deficiency (adult type hypolactasia) is the most common type of primary enzyme deficiency. Complaints related to lactose intolerance may overlap with the symptoms of IBS.

AIM

To assess the prevalence of primary hypolactasia in patients with IBS.

MATERIAL AND METHODS

The study included 56 patients with IBS diagnosed based on the Rome III criteria and 23 healthy people. All study participants completed a questionnaire on IBS symptoms and lactose intolerance, and they underwent a hydrogen breath test (HBT) with lactose. In the group of patients with positive results of HBT, the polymorphism C/T -13910 and G/A -22018 in the promoter of the LCT gene encoding lactase was determined.

RESULTS

Lactase deficiency was diagnosed in HBT in 34 (60.7%) patients with IBS and in the control group - in 10 (43.5%). Primary adult type hypolactasia was confirmed in 78.9% ( = 30; 79.3% in the study group; 77.8% in the control group). There were no statistically significant differences in the occurrence of LCT gene polymorphisms in particular IBS subtypes. Adult type hypolactasia was significantly more common in patients with severe than moderate and mild enzyme deficiency in HBT ( < 0.05).

CONCLUSIONS

The incidence of lactase deficiency in IBS patients is not different from that found in healthy subjects. Nevertheless, irrespective of the IBS subtype, lactose intolerance may pose additional issues in patients with IBS and requires the targeted treatment.

摘要

引言

肠易激综合征(IBS)中乳糖不耐受的发生率在文献中的报道有所不同(27%-72%)。原发性成人乳糖酶缺乏症(成人型低乳糖血症)是最常见的原发性酶缺乏类型。与乳糖不耐受相关的症状可能与IBS的症状重叠。

目的

评估IBS患者中原发性低乳糖血症的患病率。

材料与方法

该研究纳入了56例根据罗马III标准诊断为IBS的患者和23名健康人。所有研究参与者均完成了一份关于IBS症状和乳糖不耐受的问卷,并接受了乳糖氢呼气试验(HBT)。在HBT结果呈阳性的患者组中,对编码乳糖酶的LCT基因启动子中的C/T -13910和G/A -22018多态性进行了测定。

结果

HBT诊断出34例(60.7%)IBS患者存在乳糖酶缺乏,对照组中有10例(43.5%)存在乳糖酶缺乏。确诊为原发性成人型低乳糖血症的患者占78.9%(n = 30;研究组为79.3%;对照组为77.8%)。特定IBS亚型中LCT基因多态性的发生率无统计学显著差异。在HBT中,成人型低乳糖血症在酶缺乏严重的患者中比中度和轻度患者更为常见(P < 0.05)。

结论

IBS患者中乳糖酶缺乏症的发生率与健康受试者无异。然而,无论IBS亚型如何,乳糖不耐受可能给IBS患者带来额外问题,需要针对性治疗。

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