Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.
Department of Clinical Support, Lovisenberg Diaconal Hospital, Oslo, Norway.
Scand J Clin Lab Invest. 2024 Jul;84(4):268-272. doi: 10.1080/00365513.2024.2377960. Epub 2024 Jul 10.
Reduced activity of the sucrase-isomaltase (SI) enzyme can cause gastrointestinal symptoms. Biochemical measurement of SI activity in small intestinal biopsies is presently considered the gold standard for the diagnosis of SI deficiency, but this invasive test is not suitable as a routine diagnostic tool.
To evaluate a C-sucrose-breath test (CSBT) as a diagnostic tool for SI deficiency in an adult population.
CSBT results were compared to sucrase activity measured in duodenal biopsies.
Forty patients with gastrointestinal symptoms were included in the study, 4 of whom had celiac disease and the rest ( = 36) had normal histological findings. Nine patients (22.5%) had low sucrase activity measured using duodenal biopsies. No correlation was observed between enzymatic sucrase activity and the CSBT results. The CSBT-curves for the celiac patients versus patients with normal duodenal histology demonstrated that the patients with celiac disease were within the lower range of the distribution.
We observed a mismatch between the CSBT results and the biochemically measured sucrase activity, suggesting that SI activity is not uniformly distributed throughout the small intestines. This methodological discrepancy should be acknowledged when diagnosing SI deficiency.
蔗糖酶-异麦芽糖酶（SI）活性降低可引起胃肠道症状。目前，小肠活检中 SI 活性的生化测量被认为是诊断 SI 缺乏症的金标准，但这种有创性检查不适合作为常规诊断工具。
评估 C-蔗糖呼气试验（CSBT）作为成人 SI 缺乏症的诊断工具。
将 CSBT 结果与十二指肠活检中的蔗糖酶活性进行比较。
本研究纳入了 40 例有胃肠道症状的患者，其中 4 例患有乳糜泻，其余 36 例（ = 36）组织学检查正常。9 例（22.5%）患者的十二指肠活检显示蔗糖酶活性较低。酶促蔗糖活性与 CSBT 结果之间无相关性。乳糜泻患者和十二指肠组织学正常患者的 CSBT 曲线表明，乳糜泻患者的曲线处于较低的分布范围。
我们观察到 CSBT 结果与生化测量的蔗糖酶活性之间存在不匹配，这表明 SI 活性在小肠内不是均匀分布的。在诊断 SI 缺乏症时，应注意到这种方法学差异。
