Molecularly-defined lactose malabsorption, milk consumption and anthropometric differences in adult males
From the 1Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University, Graz, 2Division of Pathophysiology, Medical University, Vienna, 3Hospital of the Brothers of Charity, Department of Internal Medicine, Vienna, and 4Center for Medical Research, Unit of Biostatistics, Medical University, Graz, Austria
Address correspondence to Dr M. Gugatschka, Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University Hospital, Auenbruggerplatz 15, A-8036 Graz, Austria. email: markus.gugatschka{at}klinikum-graz.at
Received 10 August 2005 and in revised form 12 October 2005
Background: Lactose malabsorption (LM) may be associated with reduced skeletal calcium content. Diagnosis to date has been based on indirect methods, with a high false-negative rate. Identification of the LCT polymorphism led to development of a PCR-based test.
Aim: To evaluate the PCR-based test compared to a combination the hydrogen breath test and the lactose tolerance test, and investigate anthropometrical differences, changes in bone mineral density and oral calcium intake according to LCT polymorphism and milk-drinking habits.
Methods: All participants (n = 278) underwent clinical examination, with measurement of height, weight and bone density (DXA), and were genotyped for LCT polymorphism (LCT CC or LCT TT: CC is associated with LM). A subgroup (n = 51) had a hydrogen breath test and a lactose tolerance test, in addition to genotyping.
Results: Detection of LM by LCT polymorphism was highly significant (p = 0.001). The correlation between LCT genotype and self-reported milk-intolerance or dislike of milk with was slight, but the correlation with functional tests was highly significant. Non-milk-drinkers were lighter (–5 kg) and significantly shorter (–4 cm) than milk-drinkers (p = 0.07 and 0.04, respectively). Total calcium consumption was lower among non-milk-drinkers by about 18% (p = 0.03).
Discussion: Genotyping is an economic, quick and convenient method for diagnosing lactose malabsorption, with results comparable to existing tests. Sufficient calcium consumption may be relevant to body growth, as milk-drinkers were taller. Negative calcium bone balance may be prevented when provision is made for adequate calcium intake.
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