Lactose malabsorption is a risk factor for decreased bone mineral density in pancreatic insufficient cystic fibrosis patients

• Published in: European journal of human genetics : EJHG Vol. 20; no. 10; pp. 1092 - 1095
• Main Authors: Mądry, Edyta, Krasińska, Beata, Drzymała-Czyż, Sławomira, Sands, Dorota, Lisowska, Aleksandra, Grebowiec, Philip, Minarowska, Alina, Oralewska, Beata, Mańkowski, Przemyslaw, Moczko, Jerzy, Walkowiak, Jarosław
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.10.2012
• Subjects: Adult; Biological and medical sciences; Body Weight; Bone Demineralization, Pathologic - etiology; Bone Demineralization, Pathologic - genetics; Bone density; Bone Density - genetics; Bone mineral density; Breath Tests; Calcium; Calcium - metabolism; Child; Cholecalciferol - blood; Cholestasis; Cirrhosis; Cystic fibrosis; Cystic Fibrosis - complications; Diabetes mellitus; Fatty liver; Female; Fibrosis; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Gene polymorphism; Genetics of eukaryotes. Biological and molecular evolution; Genotypes; Glucocorticoids; Humans; Lactase; Lactase - deficiency; Lactase - genetics; Lactose; Lactose Intolerance - complications; Lactose Intolerance - genetics; Liver; Lung; Malabsorption; Male; Medical genetics; Medical sciences; Methane; Milk; Milk products; Minerals; Molecular and cellular biology; Nutrition; Nutritional status; Other diseases. Semiology; Pancreas; Polymorphism, Single Nucleotide; Promoter Regions, Genetic - genetics; Regression analysis; Risk Factors; Short Report; Single-nucleotide polymorphism; Statistical analysis; Steatosis; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Teenagers; Vitamin D; Vitamin D3; Vitamins; Young adults; Poland; Human; Respiratory disease; Metabolic diseases; Patient; Cystic fibrosis; lactose malabsorption; Genetic disease; Lactose; Intestinal malabsorption; adult-type hypolactasia; Risk factor; Digestive diseases; Intestinal disease; Adult; Genetics; Bone mineral density; Pancreas; Pancreatic disease
• ISSN: 1018-4813; 1476-5438; 1476-5438
• DOI: 10.1038/ejhg.2012.52

As decreased bone mineral density (BMD) is a common problem in cystic fibrosis (CF) and milk products may have pivotal dietary role affecting BMD, we aimed to assess the potential influence of adult-type hypolactasia (ATH) and lactose malabsorption (LM) on BMD in adolescent and young adult patients. In 95 CF pancreatic-insufficient patients aged 10-25 years (without liver cirrhosis, steatosis and cholestasis, diabetes mellitus, systemic glucocorticoid therapy), lumbar BMD, the nutritional status, pulmonary function, vitamin D3 concentration, calcium intake and single-nucleotide polymorphism upstream of the lactase gene were assessed. In subjects with the -13910 C/C genotype predisposing to ATH, the presence of LM was determined with the use of a hydrogen-methane breath test (BT). BMD and calcium intake were significantly lower in patients with the C/C genotype (P<0.028 and P<0.043, respectively). The abnormal BMD was stated more frequently in patients with the C/C genotype (P<0.042) and with LM (P<0.007). BMD, daily calcium intake and serum vitamin D concentration were significantly lower in LM subjects than in the other patients (P<0.037, P<0.000004 and P<0.0038, respectively). In logistic regression analysis, the relationship between examined parameters and BMD, was found to be statistically significant (P<0.001). However, only standardized body weight and LM were documented to influence BMD (P<0.025 and P<0.044, respectively). In conclusion, LM seems to be an independent risk factor for decreased BMD in CF patients.