Assessment of Hypolactasia and Site-Specific Intestinal Permeability by Differential Sugar Absorption of Raffinose, Lactose, Sucrose and Mannitol

Verfasser / Beitragende:
[Jan Hessels, Harry H. M. Eidhof, Jan Steggink, Wilfried W. H. Roeloffzen, Kalung Wu, Guy Tan, Jan van de Stadt, Leo van Bergeijk]
Ort, Verlag, Jahr:
2003
Enthalten in:
Clinical Chemistry and Laboratory Medicine, 41/8(2003-08-07), 1056-1063
Format:
Artikel (online)
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024 7 0 |a 10.1515/CCLM.2003.163  |2 doi 
035 |a (NATIONALLICENCE)gruyter-10.1515/CCLM.2003.163 
245 0 0 |a Assessment of Hypolactasia and Site-Specific Intestinal Permeability by Differential Sugar Absorption of Raffinose, Lactose, Sucrose and Mannitol  |h [Elektronische Daten]  |c [Jan Hessels, Harry H. M. Eidhof, Jan Steggink, Wilfried W. H. Roeloffzen, Kalung Wu, Guy Tan, Jan van de Stadt, Leo van Bergeijk] 
520 3 |a The sugar absorption test is a non-invasive test for investigating intestinal permeability by simultaneous measurement of four probe sugars. In this study, we evaluated the utility of raffinose, lactose, sucrose and mannitol as probe sugars and calculated their urinary recovery as a percentage of ingested dose (mol/mol) and the recovery ratios of raffinose/mannitol, lactose/raffinose and sucrose/raffinose. The reference ranges for these ratios, established from 39 healthy volunteers, are 0.005-0.015, 0.13-0.63 and 0.09-0.47, respectively. This sugar absorption test was performed in three patient groups. i) In 109 patients with aspecific gastrointestinal symptoms of whom intestinal histology was studied by duodenal biopsies: the urinary raffinose/mannitol recovery ratio highly correlated with gradation of duodenal damage; the sensitivity and specificity of the raffinose/mannitol ratio for detection of intestinal damage were 93% and 91%, respectively, using a cut-off level of 0.020. ii) In 70 patients in whom intestinal lactase activity was investigated by the lactose tolerance test: the urinary lactose/raffinose recovery ratio provided high diagnostic accuracy for hypolactasia (sensitivity 81% and specificity 89% at a cut-off level of 0.70). In analogy with the lactose/raffinose ratio, we suppose that the sucrose/raffinose ratio can be used as a marker of hyposucrasia. iii) In 40 patients with localized small intestinal damage, Crohns disease of the ileum (n = 21) and celiac disease with histologically proven duodenal damage (n = 19): the raffinose/mannitol recovery ratio was increased in 100% of patients with celiac disease and in 81% of patients with Crohns disease; increased lactose/raffinose recovery ratio (hypolactasia) and increased sucrose/raffinose (hyposucrasia) were present in 89% and 95% of celiac patients and 19% and 0% of Crohn's disease patients, respectively. The combination of the raffinose/mannitol ratio and sucrose/raffinose ratio appears to be an indication of the distribution of intestinal damage. 
540 |a Copyright © 2003 by Walter de Gruyter GmbH & Co. KG 
690 7 |a Medical equipment & techniques  |2 nationallicence 
690 7 |a Medical diagnosis  |2 nationallicence 
690 7 |a Diseases & disorders  |2 nationallicence 
700 1 |a Hessels  |D Jan  |4 aut 
700 1 |a Eidhof  |D Harry H. M.  |4 aut 
700 1 |a Steggink  |D Jan  |4 aut 
700 1 |a Roeloffzen  |D Wilfried W. H.  |4 aut 
700 1 |a Wu  |D Kalung  |4 aut 
700 1 |a Tan  |D Guy  |4 aut 
700 1 |a Stadt  |D Jan van de  |4 aut 
700 1 |a Bergeijk  |D Leo van  |4 aut 
773 0 |t Clinical Chemistry and Laboratory Medicine  |d Walter de Gruyter  |g 41/8(2003-08-07), 1056-1063  |x 1434-6621  |q 41:8<1056  |1 2003  |2 41  |o cclm 
856 4 0 |u https://doi.org/10.1515/CCLM.2003.163  |q text/html  |z Onlinezugriff via DOI 
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950 |B NATIONALLICENCE  |P 773  |E 0-  |t Clinical Chemistry and Laboratory Medicine  |d Walter de Gruyter  |g 41/8(2003-08-07), 1056-1063  |x 1434-6621  |q 41:8<1056  |1 2003  |2 41  |o cclm 
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