Disaccharidase activities in children: Normal values and comparison based on symptoms and histologic changes

被引:47
作者
Gupta, SK [1 ]
Chong, SKF [1 ]
Fitzgerald, JF [1 ]
机构
[1] Indiana Univ, Med Ctr, James Whitcomb Riley Hosp Children, Div Pediat Gastroenterol, Indianapolis, IN 46202 USA
关键词
normal disaccharidase activities; pediatrics;
D O I
10.1097/00005176-199903000-00007
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: The relationship between symptoms, intestinal mucosal histology, and disaccharidase activities is not well defined. An analysis of disaccharidase activities was performed in children grouped by age, symptoms, and intestinal mucosal histology and normal values established. Methods: Disaccharidase activities and histology of 246 endoscopically obtained duodenal biopsies in 232 patients (121 girls; age range, 0.08-17 years; mean, 5.9 years) in a 3-year period were reviewed. Patients were divided into two groups based on absence (group 1; n = 142) or presence (group 2; n = 90) of diarrhea and were subdivided by age into, less than 24 months of age and 24 months of age or more. Histologic changes within groups were classified as (A) normal, (B) mild, or (C) moderate to severe based on villus height abnormalities. A questionnaire was sent to 34 patients with hypolactasia to assess the efficacy of lactose avoidance and/or lactase supplementation. Results: All group I patients had normal findings in analysis of mucosal specimens, and their disaccharidase activities showed normal values because they had no diarrhea. The geometric means (95% confidence interval) in children aged less than 24 months are (in micromoles of substrate hydrolyzed per minute at 37 degrees C per gram protein) (units [U]) lactase, 36.7 (13.3-100.4); maltase, 178.5 (88.9-356.3); palatinase, 12.7 (3.8-41.5); and sucrase 60.0 (24.0-148.1). In children 24 months of age or more, the values are 23.2 (3.9-108.1), 167.6 (78.8-355.9), 12.7 (4.9-32.9), and 51.0 (20.5-126.0), respectively. Only lactase activity decreased with age (p < 0.05). No differences in disaccharidase activities were noted in patients with and without diarrhea if the mucosal histology was normal (group 1A vs. 2A). In patients with diarrhea, values were commensurate with the degree of mucosal injury, especially in the older group. Twenty-two of 27 patients (81%) who responded to the questionnaire had benefited from lactase supplementation and/or lactose avoidance. Conclusions: We have established normal values for disaccharidase activities in the pediatric population. Although the disaccharidase activities correlate more with degree of intestinal mucosal injury than with symptoms, their activities are difficult to predict accurately based on these criteria. If required, disaccharidase activities should be measured biochemically.
引用
收藏
页码:246 / 251
页数:6
相关论文
共 21 条
[2]  
BANAI J, 1990, AM J GASTROENTEROL, V85, P157
[3]  
BARNES GL, 1988, AUST PAEDIATR J, V24, P31
[4]   DUODENAL MUCOSAL DAMAGE IN 31 INFANTS WITH GASTROENTERITIS [J].
BARNES, GL ;
TOWNLEY, RRW .
ARCHIVES OF DISEASE IN CHILDHOOD, 1973, 48 (05) :343-349
[5]   DISACCHARIDASE ACTIVITIES, JEJUNAL MORPHOLOGY, AND CARBOHYDRATE-TOLERANCE IN CHILDREN WITH CHRONIC DIARRHEA [J].
CALVIN, RT ;
KLISH, WJ ;
NICHOLS, BL .
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 1985, 4 (06) :949-953
[6]   ORNITHINE TRANSCARBAMYLASE AND DISACCHARIDASE ACTIVITIES IN DAMAGED INTESTINAL-MUCOSA OF CHILDREN - DIAGNOSIS OF HEREDITARY ORNITHINE TRANSCARBAMYLASE DEFICIENCY IN MUCOSA [J].
CATHELINEAU, L ;
BRIAND, P ;
RABIER, D ;
NAVARRO, J .
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 1985, 4 (06) :960-964
[7]  
DESOUSA JS, 1984, J PEDIATR GASTR NUTR, V3, P321
[8]  
EGGERMONT E, 1981, PEDIATR RES, V15, P1205
[9]   DIAMINE OXIDASE AND DISACCHARIDASE ACTIVITIES IN SMALL INTESTINAL BIOPSIES OF CHILDREN [J].
FORGET, P ;
GRANDFILS, C ;
VANCUTSEM, JL ;
DANDRIFOSSE, G .
PEDIATRIC RESEARCH, 1984, 18 (07) :647-649
[10]   LACTASE INSUFFICIENCY REVISITED [J].
FORGET, P ;
LOMBET, J ;
GRANDFILS, C ;
DANDRIFOSSE, G ;
GEUBELLE, F .
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 1985, 4 (06) :868-872