Lactose intolerance

乳糖不耐受
  • 文章类型: Journal Article
    目的:研究已经确定,具有遗传定义的乳糖酶非持久性的人的乳制品摄入量较低,这可能导致各种非传染性疾病的风险增加。此外,乳糖酶的非持久性本身与胰岛素抵抗有关。然而,发展中国家乳糖酶非持久性状态和乳制品摄入量的数据很少。因此,我们旨在定义1)泰国人群中糖尿病和非糖尿病个体中乳糖酶非持久性的患病率,以及2)乳糖酶非持久性之间的联系,牛奶消费,和糖尿病的风险。
    方法:我们对全国健康检查调查的参与者进行了病例对照研究。从血液中分离出LCT-13910C>T(rs4988235)多态性的DNA,并使用Bio-radc1000触摸热循环仪和MALDI-TOF质谱MassARRAYTyperv4.0(AgenaBioscience,圣地亚哥,CA,美国)在医学基因组学中心,医学院Ramathibodi医院。病例为先前诊断为糖尿病或空腹血糖≥126mg/dL(n=1,756)与控件(n=2,380)。
    结果:我们包括4,136名参与者,62%女性,98.8%>30岁。纯合CC基因型(即,乳糖酶非持久性)占98.6%,只有1.4%携带杂合CT。大多数(76%)每月食用牛奶<1份。具有CC或CT基因型的参与者的牛奶摄入量和糖尿病风险相当。男性,老年人,教育程度较低的人每月至少食用一份牛奶的机会较低。除了各种基线变量,我们发现,较高的牛奶摄入量与较低的DM风险相关(P=0.01)。
    结论:泰国人群中乳糖酶非持久性的患病率非常高。未发现与乳糖酶非持久性状态相关的牛奶消费频率存在显着差异。然而,较高的牛奶摄入量与较低的糖尿病风险相关。
    Studies have determined that people with genetically defined lactase non-persistence have lower dairy intake that may lead to an increase risk of various non-communicable diseases. Furthermore, lactase non-persistence itself has been associated with insulin resistance. However, data on lactase non-persistence status and dairy intake in developing countries are sparse. We therefore aimed to define 1) the prevalence of lactase non-persistence among individuals with diabetes and non-diabetes in Thai population and 2) the links between lactase non-persistence, milk consumption, and risk of diabetes mellitus.
    We conducted a case-control study from participants of the National Health Examination Survey. DNA was isolated from the blood for LCT -13910C>T (rs4988235) polymorphism and processed using the Bio-rad c1000 touch thermal cycler and MALDI-TOF Mass Spectrometry MassARRAY Typer v4.0 (Agena Bioscience, San Diego, CA, USA) at the Center for Medical Genomics, Faculty of Medicine Ramathibodi Hospital. Cases were participants with previously diagnosed diabetes mellitus or fasting plasma glucose ≥126 mg/dL (n = 1,756) vs. the controls (n = 2,380).
    We included 4,136 participants, 62% female, and 98.8% were > 30 years old. Homozygous CC genotype (i.e., lactase non-persistence) was noted in 98.6% and only 1.4% carried heterozygous CT. Most (76%) consumed milk <1 portion/month. Participants with either CC or CT genotype had comparable milk consumption and the risk of diabetes mellitus. Males, older adults, and lower education had a lower chance of consuming milk at least one portion per month. Besides various baseline variables, we found that higher milk consumption was associated with a lower DM risk (P = .01).
    The prevalence of lactase non-persistence in Thai population is very high. A significant difference in milk consumption frequency in relation to the lactase non-persistence status was not found. However, higher milk consumption is associated with a lower risk of diabetes mellitus.
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  • 文章类型: Case Reports
    未经证实:在患有神经性厌食症(AN)的患者中经常观察到胃肠道(GI)不适。这些症状可能会阻碍治疗和体重恢复,并且通常被认为是原因,不是后果,的疾病。由于碳水化合物吸收不良也会产生这些症状,这可能是这些投诉的基础或促成这些投诉的原因。到目前为止,尚未研究在AN中碳水化合物吸收不良(果糖吸收不良和乳糖不耐受)的作用。
    UNASSIGNED:对于此案例系列,住院限制性AN患者(n=3),吹扫类型(n=3),和非典型AN(n=1)用25g果糖和50g乳糖进行了氢呼气试验,以研究碳水化合物吸收不良。然后将结果与体重指数(BMI)和患者报告的结果(饮食失调,身体图像干扰,焦虑,抑郁症状,感知压力,和GI投诉)。
    UNASSIGNED:根据氢呼气试验结果,7例女性患者中有3例被归类为乳糖不耐受,1例出现果糖吸收不良。果糖(r=-0.632,p<0.001)和乳糖(r=-0.704,p<0.001)的氢曲线均与BMI呈负相关。在氢值和患者报告的结果之间没有观察到关联。
    未经证实:在AN患者中,由常见单糖和二糖不耐受引起的胃肠道症状可能是一种低估的负担,应在AN患者的诊断和治疗中予以考虑。由于观察到与BMI的相关性,摄入果糖或乳糖后的胃肠道不适可能随着体重的减少而发展,并且随着体重的恢复而可能可逆。
    UNASSIGNED: Gastrointestinal (GI) complaints are frequently observed in patients who suffer from anorexia nervosa (AN). These symptoms may hamper treatment and weight regain and are often perceived as the cause, not the consequence, of the disease. Since carbohydrate malabsorption also produces these symptoms, this might underly or contribute to these complaints. So far, the role of carbohydrate malabsorption (fructose malabsorption and lactose intolerance) in AN has not yet been investigated.
    UNASSIGNED: For this case series, inpatients with AN of restrictive type (n = 3), purging type (n = 3), and atypical AN (n = 1) conducted hydrogen breath tests with 25 g of fructose and 50 g of lactose to investigate carbohydrate malabsorption. Results were then analyzed in association with body mass index (BMI) and patient-reported outcomes (disordered eating, body image disturbances, anxiety, depressive symptoms, perceived stress, and GI complaints).
    UNASSIGNED: Based on the hydrogen breath test results, three of the seven female patients were classified as lactose intolerant and one presented fructose malabsorption. Both hydrogen curves for fructose (r = -0.632, p < 0.001) and lactose (r = -0.704, p < 0.001) showed a negative correlation with BMI. No association was observed between hydrogen values and patient-reported outcomes.
    UNASSIGNED: In patients with AN, GI symptoms caused by intolerance of common monosaccharides and disaccharides may be an underestimated burden and should be considered in the diagnosis and therapy of patients with AN. Due to the observed correlation with BMI, GI complaints after ingestion of fructose or lactose likely develop with decreasing body weight and are potentially reversible with weight regain.
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  • 文章类型: Journal Article
    为了评估避免使用乳制品的普遍性和解释,包括归因于它们的消耗的症状,回避的诊断和心理预测因素。还考虑了同一样品中与症状相关的小麦回避的比较。
    横断面人口调查。
    这项研究是在澳大利亚使用国家邮政综合调查进行的。
    从澳大利亚选民名册中随机选择的18岁及以上的成年人(n1184;52·9%的女性)。
    尽管很少有正式诊断为过敏或不耐受的说法,11·8%的样本报告由于不利的生理影响而避免乳制品,通常包括胃肠道症状。与小麦(3·5%)或小麦和乳制品(3·6%)不同,避免乳制品(8.2%)是按年龄(负面)和担心疾病(正面)预测的。
    这些发现进一步证明了消费者普遍倾向于通过在没有医学证据或监督的情况下消除被认为可疑的饮食因素来控制自己的健康。未解决的问题包括避免乳制品的决策过程,症状是否正确归因,所涉及的药剂和生理机制,症状严重程度和警惕性对疾病担忧关联的相对贡献,以及乳制品回避者饮食的营养充足性。无论自我诊断的准确性如何,如果消除可疑食物本身就是目的,那么营养失衡的矛盾可能性可能会对公共健康产生重大影响。
    To assess the prevalence of and explanations for the avoidance of dairy foods, including symptoms attributed to their consumption, diagnoses and psychological predictors of avoidance. Also considered were comparisons with symptom-related avoidance of wheat in the same sample.
    Cross-sectional population survey.
    The study was conducted in Australia using a national postal omnibus survey.
    Adults aged 18 years and over (n 1184; 52·9 % female) selected at random from the Australian Electoral Roll.
    Despite few claims of formally diagnosed allergy or intolerance, 11·8 % of the sample reported avoiding dairy products because of adverse physiological effects, which commonly included gastrointestinal symptoms. Unlike wheat (3·5 %) or wheat-and-dairy (3·6 %) avoidance, dairy avoidance (8·2 %) was predicted by age (negatively) and worry about illness (positively).
    The findings are further evidence of a widespread tendency for consumers to exercise control over their health by eliminating dietary factors considered suspect without medical evidence or oversight. Unanswered questions include the decision processes underlying dairy avoidance, whether symptoms are attributed correctly, the agents and physiological mechanism(s) involved, the relative contributions of symptom severity and vigilance to the association with illness worry, and the nutritional adequacy of dairy avoiders\' diets. Irrespective of the accuracy of self-diagnoses, if the elimination of suspect foods is an end in itself the paradoxical possibility for nutritional imbalances may have significant public health implications.
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  • 文章类型: Journal Article
    Model checking is a generic verification technique that allows the phylogeneticist to focus on models and specifications instead of on implementation issues. Phylogenetic trees are considered as transition systems over which we interrogate phylogenetic questions written as formulas of temporal logic. Nonetheless, standard logics become insufficient for certain practices of phylogenetic analysis since they do not allow the inclusion of explicit time and probabilities. The aim of this paper is to extend the application of model checking techniques beyond qualitative phylogenetic properties and adapt the existing logical extensions and tools to the field of phylogeny. The introduction of time and probabilities in phylogenetic specifications is motivated by the study of a real example: the analysis of the ratio of lactose intolerance in some populations and the date of appearance of this phenotype.
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  • 文章类型: Case Reports
    We report on a female patient affected by galactosemia in whom the diagnosis was obscured by the concomitant presence of manifestations suggesting a cow\'s milk intolerance. This case exemplifies the problems in reaching a correct diagnosis in patients with metabolic diseases.
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  • 文章类型: Case Reports
    一名44岁的骨质疏松症女性没有相关的胃肠道症状,也没有避免任何特定的食物。然而,在补充富含乳糖的钙的处方后,出现可疑乳糖不耐受的临床症状,此后通过乳糖耐受试验证实。乳糖不耐受可能仅有轻微或微妙的症状。含乳糖的药物可诱发或增加乳糖不耐受患者的胃肠道症状。如果在开始使用含乳糖的药物后出现胃肠道症状,应考虑乳糖不耐受的可能性,并通过乳糖耐受试验或LCT(-13910)多态性基因检测进行检测.由于奥地利人口中约有15-25%的乳糖不耐受患病率,无乳糖药物应尽可能广泛地开处方。
    A 44 yr-old female with osteoporosis had no relevant gastrointestinal symptoms and did not avoid any specific food. However, after prescription of a lactose-rich calcium supplementation, clinical symptoms suspicious for lactose intolerance occurred, which were thereafter confirmed by a lactose tolerance test. Lactose intolerance may present with only slight or subtle symptoms. Drugs containing lactose may induce or increase gastrointestinal symptoms in patients with lactose intolerance. In case of gastrointestinal symptoms occurring after the initiation of drugs containing lactose, the possibility of lactose intolerance should be considered and tested by lactose tolerance test or genetic testing for the LCT (-13910) polymorphism. Due to the prevalence of about 15-25% lactose intolerance in the Austrian population, lactose free drugs should be prescribed as widely as possible.
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  • DOI:
    文章类型: Case Reports
    Diagnosis of celiac disease in a patient with lactose intolerance has special importance having implications for the treatment of both diseases. The authors present the case of a 2 years old girl, first diagnosed with enterocolitis, but her clinical evolution revealed a complex situation: both celiac disease and secondary lactose intolerance. We present the case as a special situation in clinical pediatric practice that must be taken into account more often.
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  • DOI:
    文章类型: Case Reports
    目的:牛奶配方食品可引起婴儿牛奶蛋白过敏(CMPA)。本文讨论了暴露于酪蛋白配方的婴儿中的两例严重CMPA。
    方法:病例N°1:一个7天大的男孩出现腹泻,尽管使用了几个疗程的抗生素并改用不含乳糖的配方奶粉,但没有改善。在2个月大时,他的血红蛋白为8.6mg/dL,IgE=17.8IU/ml(正常<1.5UI/ml)和CD4/CD8比率=0.16(正常1.5-2.5)。上内镜活检显示十二指肠萎缩。他接受了酪蛋白水解物配方,粪便流量减少,但腹泻持续。在3个月的生命中,他被改为氨基酸配方,并在<48小时内停止腹泻,恢复正常生长和十二指肠组织学正常化。病例2:一个10个月大的男孩有6天的呕吐史,腹泻和水肿。他的白蛋白为2.35mg/dL。上消化道内镜活检显示十二指肠严重萎缩。他接受了具有良好耐受性和水肿消退的酪蛋白水解物。在26个月大的时候,内镜下十二指肠活检显示粘膜再生。
    结论:CMPA是幼儿的常见诊断,可与感染混淆。早期诊断是取得积极结果的关键。
    OBJECTIVE: Milk-based formulas can induce cow’s milk protein allergy (CMPA) in infants. This article discusses two cases of severe CMPA in infants exposed to casein-based formulas.
    METHODS: Case N°1: A 7 day old boy developed diarrhea with no improvement despite several courses of antibiotic and switching to formula without lactose. At 2 months of age he had a hemoglobin 8.6 mg/dL, IgE = 17.8 IU/ml (normal <1.5 UI/ml) and a CD4/CD8 ratio = 0.16 (normal 1.5 – 2.5). Upper endoscopy biopsies showed duodenal atrophy. He received a casein hydrolysate formula with decreased fecal flow but continued diarrhea. At 3 months of life he was changed to an amino acid formula with cessation of diarrhea in < 48 hours, resumption of normal growth and normalization of duodenal histology. Case N°2: A 10 month old boy had a 6-day history of vomiting, diarrhea and edema. His albumin was 2.35 mg/dL. An upper endoscopy biopsy showed severe duodenal atrophy. He received a casein hydrolysate with good tolerance and resolution of the edema. At 26 months of age, and endoscopic duodenal biopsy showed regeneration of the mucosa.
    CONCLUSIONS: The CMPA is a frequent diagnosis in young infants that can be confused with infection. An early diagnosis is key to a positive outcome.
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  • DOI:
    文章类型: Case Reports
    我们报告了一例X连锁的小脑畸形,call体缺失和生殖器异常(XLAG)表现出严重腹泻的临床过程。患者表现出乳糖不耐受,他的顽固性癫痫发作在无乳糖治疗下得到缓解,广泛水解乳清蛋白配方。在用抗过敏配方治疗的2岁时,他患有严重腹泻,类似于水样腹泻-低钾血症-酸中毒综合征(WDHA)。奥曲肽可有效缓解他的分泌性腹泻。空腹时出现无高胰岛素血症的低血糖,当他患有WDHA样腹泻时,血浆血管活性肠多肽没有增加。尽管ARX突变小鼠的胰腺显示β和δ细胞数量增加,我们没有通过胰腺内分泌学发现低血糖和分泌性腹泻的原因。他的泌尿检查结果模仿了Fanconi综合征的症状,所以他的高醛固酮血症可能不仅影响了他的肠道,还有他的肾小管.
    We report the clinical course of a case of X-linked lissencephaly with absent corpus callosum and abnormal genitalia (XLAG) exhibiting severe diarrhea. The patient demonstrated lactose intolerance and his intractable seizures were relieved with lactose-free, extensively hydrolyzed whey protein formula. At the age of 2 years while being treated with the antiallergic formula, he was affected with severe diarrhea that resembled watery diarrhea-hypokalemia-acidosis syndrome (WDHA). Administration of octreotide was effective in relieving his secretory diarrhea. Hypoglycemia without hyperinsulinemia was seen during fasting, and plasma vasoactive intestinal polypeptide was not increased when he had WDHA-like diarrhea. Although pancreas of ARX mutant mice revealed an increased number of beta and delta cells, we did not detect the cause of hypoglycemia and secretory diarrhea by pancreatic endocrinology. His urinary findings mimicked the symptoms of Fanconi syndrome, so it was possible that his hyperaldsteronemia affected not only his intestinal tract, but also his renal tubules.
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  • 文章类型: Journal Article
    背景:妊娠期间和分娩后(PPP)的长期盆腔疼痛很常见。其原因尚未完全了解。一个科学,无证,临床观察是PPP患者经常报告非特异性腹痛和牛奶不良反应。这项初步研究的主要目的是调查乳糖不耐受,乳糜泻或过敏倾向是分娩后发生盆腔疼痛的危险因素。
    方法:A匹配,病例对照研究,将咨询专门治疗产后盆腔疼痛妇女的注册物理治疗师的连续患者与匹配的对照组进行比较。
    结果:15例患者中有10例发现乳糖不耐受,在15个匹配中的3个中,健康对照(p=0.05)。两组之间乳糜泻或过敏倾向的患病率没有差异。
    结论:本研究提示乳糖不耐受可能是分娩后盆腔疼痛的危险因素。
    BACKGROUND: Long-standing pelvic pain during pregnancy and after delivery (PPP) is common. Its causes are not fully understood. A scientifically, undocumented, clinical observation is PPP patients often reporting unspecific abdominal pain and adverse reactions to milk. The main objective in this pilot study was to investigate if lactose intolerance, celiac disease or allergic propensity are risk factors for developing pelvic pain after delivery.
    METHODS: A matched, case control study,where consecutive patients consulting a registered physiotherapist specialised in treating women with postpartum pelvic pain were compared to matched controls.
    RESULTS: Lactose intolerance was found in 10 of 15 patients, and in 3 of 15 matched, healthy controls (p=0.05). No difference was seen between groups in the prevalence of celiac disease or allergic propensity.
    CONCLUSIONS: This study suggests that lactose intolerance might be a possible risk factor for pelvic pain after delivery.
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