caa a22 4500 37888140X CHVBK 20180305123432.0 cr unu---uuuuu 161128e20030807xx s 000 0 eng 10.1515/CCLM.2003.163 doi (NATIONALLICENCE)gruyter-10.1515/CCLM.2003.163 Assessment of Hypolactasia and Site-Specific Intestinal Permeability by Differential Sugar Absorption of Raffinose, Lactose, Sucrose and Mannitol [Elektronische Daten] [Jan Hessels, Harry H. M. Eidhof, Jan Steggink, Wilfried W. H. Roeloffzen, Kalung Wu, Guy Tan, Jan van de Stadt, Leo van Bergeijk] 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. Copyright © 2003 by Walter de Gruyter GmbH & Co. KG Medical equipment & techniques nationallicence Medical diagnosis nationallicence Diseases & disorders nationallicence Hessels Jan aut Eidhof Harry H. M. aut Steggink Jan aut Roeloffzen Wilfried W. H. aut Wu Kalung aut Tan Guy aut Stadt Jan van de aut Bergeijk Leo van aut Clinical Chemistry and Laboratory Medicine Walter de Gruyter 41/8(2003-08-07), 1056-1063 1434-6621 41:8<1056 2003 41 cclm https://doi.org/10.1515/CCLM.2003.163 text/html Onlinezugriff via DOI 1 research article jats NATIONALLICENCE 856 40 https://doi.org/10.1515/CCLM.2003.163 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hessels Jan aut NATIONALLICENCE 700 1- Eidhof Harry H. M. aut NATIONALLICENCE 700 1- Steggink Jan aut NATIONALLICENCE 700 1- Roeloffzen Wilfried W. H. aut NATIONALLICENCE 700 1- Wu Kalung aut NATIONALLICENCE 700 1- Tan Guy aut NATIONALLICENCE 700 1- Stadt Jan van de aut NATIONALLICENCE 700 1- Bergeijk Leo van aut NATIONALLICENCE 773 0- Clinical Chemistry and Laboratory Medicine Walter de Gruyter 41/8(2003-08-07), 1056-1063 1434-6621 41:8<1056 2003 41 cclm CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-gruyter