Johnson J D, Simoons F J, Hurwitz R, Grange A, Mitchell C H, Sinatra F R, Sunshine P, Robertson W V, Bennett P H, Kretchmer N
Gastroenterology. 1977 Dec;73(6):1299-304.
Lactose loading tests and other means were used to determine the pattern of primary "adult" lactose malabsorption (LM) and milk use among 171 subjects, including 122 children and 49 adults, almost all of them Pima Indians of Arizona. LM develops at quite young ages in full-blooded Pima children: already in the 3- to 4-year age group, 40% had LM. Of 62 full-blooded Indians (greater than or equal to 4 years of age), 59 (95%) had LM. Of 41 Indians (greater than or equal to 4 years) who were of mixed Indian-northern European ancestry, however, only 25 (61%) had LM, and, among them, prevalence of LM correlated with degree of northern European admixture. Whereas only 21% of Pima lactose absorbers reported symptoms after the loading test, 72% of malabsorbers did so, with older malabsorbers more likely to experience symptoms. In their everyday lives, only 23% of malabsorbers recognized symptoms brought on by milk consumption, but the percentage of malabsorbers making such an association increased with age. Nevertheless the Pima, adults as well as children, continue to drink reasonable quantities of milk. Family pedigrees are consistent with the hypothesis that adult lactose absorption is inherited as an autosomal dominant trait. Over-all results of this study, moreover, support the geographic hypothesis advanced to explain ethnic or racial differences in prevalence of LM, rather than the induction hypothesis.
乳糖负荷试验及其他方法被用于确定171名受试者（包括122名儿童和49名成人，几乎所有人都是亚利桑那州的皮马印第安人）中原发性“成人”乳糖吸收不良（LM）的模式及牛奶的饮用情况。纯种皮马儿童在很小的时候就会出现LM：在3至4岁年龄组中，已有40%的儿童出现LM。在62名年龄大于或等于4岁的纯种印第安人中，59名（95%）有LM。然而，在41名有印第安人与北欧人混合血统且年龄大于或等于4岁的印第安人中，只有25名（61%）有LM，并且在他们当中，LM的患病率与北欧血统的混合程度相关。虽然只有21%的皮马乳糖吸收者在负荷试验后报告有症状，但72%的吸收不良者有症状，年龄较大的吸收不良者更易出现症状。在日常生活中，只有23%的吸收不良者认识到饮用牛奶会引发症状，但认识到这一点的吸收不良者的比例随年龄增加。尽管如此，皮马人，无论成人还是儿童，仍继续饮用适量的牛奶。家族谱系与成人乳糖吸收作为常染色体显性性状遗传的假说一致。此外，本研究的总体结果支持为解释LM患病率的种族或民族差异而提出的地理假说，而非诱导假说。
