Laserna Mendieta Emilio José, Martín Dominguez Verónica, Pérez Lucendo Irene, Granero Cremades Inmaculada, Ferreirós Martínez Raquel, Álvarez Malé Tomás, Sanz De Benito María Ángeles, Santander Cecilio
Gastroenterology Research Unit, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain.
Service of Clinical Laboratory, Hospital Universitario La Princesa, Madrid, Spain.
Adv Lab Med. 2024 Aug 9;5(3):327-332. doi: 10.1515/almed-2024-0115. eCollection 2024 Sep.
Exhaled breath tests (BTs) are the main diagnostic method for fructose and lactose malabsorption/intolerance (FI and LI, respectively) and for detecting small intestine bacterial or methanogen overgrowth (SIBO/IMO). Although FI/LI-BTs may provide evidence of the presence of SIBO/IMO, there is limited literature evaluating their reliability for this purpose. The objective of this study was to assess the sensitivity and specificity of FI/LI-BTs in detecting SIBO and their concordance with SIBO-BTs in the identification of IMO.
In this retrospective observational study, FI/LI-BTs and SIBO-BTs performed in the same patients within a period of 6 weeks were selected from 652 gas chromatography-based BTs.
A total of 146 BTs from 67 eligible adult patients were identified. LI-BTs had higher specificity than FI-BT in detecting SIBO (93.8 % vs. 72.7 %). In contrast, FI-BTs showed higher sensitivity (60.0 % vs. 28.6 %) as FI was more frequently established in SIBO-positive patients (70 % vs. 29 %). With regard to IMO, concordance with LI-BT was 100 %, with a 27 % of false negatives on FI-BTs.
Findings suggestive of SIBO or IMO on LI-BTs were highly consistent with those of SIBO-BTs. In contrast, the rate of false positives for SIBO and the rate of false negative for IMO on FI-BTs was 27 % in both cases.
呼气试验（BTs）是诊断果糖和乳糖吸收不良/不耐受（分别为FI和LI）以及检测小肠细菌或产甲烷菌过度生长（SIBO/IMO）的主要方法。尽管FI/LI-BTs可能为SIBO/IMO的存在提供证据，但评估其在此方面可靠性的文献有限。本研究的目的是评估FI/LI-BTs在检测SIBO方面的敏感性和特异性，以及它们与SIBO-BTs在识别IMO方面的一致性。
在这项回顾性观察研究中，从652次基于气相色谱的BTs中选取了在6周内对同一患者进行的FI/LI-BTs和SIBO-BTs。
共识别出67例符合条件的成年患者的146次BTs。LI-BTs在检测SIBO方面比FI-BT具有更高的特异性（93.8%对72.7%）。相比之下，FI-BTs显示出更高的敏感性（60.0%对28.6%），因为在SIBO阳性患者中FI更频繁出现（70%对29%）。关于IMO，与LI-BT的一致性为100%，FI-BTs上有27%的假阴性。
LI-BTs上提示SIBO或IMO的结果与SIBO-BTs的结果高度一致。相比之下，FI-BTs上SIBO的假阳性率和IMO的假阴性率在两种情况下均为27%。
