McDonald G B, Earnest D L, Admirand W H
Gut. 1977 Jul;18(7):561-6. doi: 10.1136/gut.18.7.561.
The effect of fat malabsorption on the absorption and renal excretion of dietary oxalate was studied in four patients with sprue and in two patients with dermatitis herpetiformis and sprue-like jejunal histology. Hyperoxaluria was present in all patients with sprue when fat malabsorption was severe. Urinary oxalate excretion decreased in two of the three patients with coeliac sprue when their fat malabsorption had improved after three months of dietary gluten restriction. Neither patient with dermatitis herpetiformis and sprue had steatorrhoea. In these patients, urinary oxalate excretion was always within normal limits. A significant positive linear relationship (y=28.25 +4-84x; r=0-82; P less than 0-01) was demonstrated between faecal fat and urinary oxalate excretion. The results of this study support the concept that severe malabsorption of dietary fat plays a primary causative role in enteric hyperoxaluria.
在4例口炎性腹泻患者及2例疱疹样皮炎且空肠组织学类似口炎性腹泻的患者中，研究了脂肪吸收不良对膳食草酸盐吸收及肾排泄的影响。当脂肪吸收不良严重时，所有口炎性腹泻患者均出现高草酸尿症。3例乳糜泻患者中，有2例在进行3个月的无麸质饮食限制后脂肪吸收不良改善，其尿草酸盐排泄减少。疱疹样皮炎合并口炎性腹泻的患者均无脂肪泻。在这些患者中，尿草酸盐排泄始终在正常范围内。粪便脂肪与尿草酸盐排泄之间呈显著的正线性关系（y = 28.25 + 4.84x；r = 0.82；P < 0.01）。本研究结果支持以下观点：膳食脂肪的严重吸收不良在肠道高草酸尿症中起主要致病作用。
