BACKGROUND AND AIMS: Lactase non-persistence causes gastrointestinal symptoms after milk ingestion. Hydrogen breath test (BTH) and genotyping of a single nucleotide polymorphism (SNP) C >T 13,910 base pairs upstream of the lactase gene represent potential methods for diagnosis of this autosomal-recessive trait. The aim of the study was to compare the results of both tests in detecting lactose non-persistence in a tertiary referral centre. PATIENTS: A group of 58 patients admitted to a German university hospital for symptoms suggesting lactose intolerance. METHODS: BTH after lactose ingestion (50 g) and SNP -13,910C>T genotyping using single nucleotide primer extension (SNaPshot) technology (CC genotype--lactase non-persistence; TC/TT genotypes--lactase persistence). RESULTS: Overall, 17 (29%) patients had a positive and 41 (71%) had a negative BTH result; 15 (26%) patients were CC-positive and 43 (74%) were CC-negative [28 (48%) TC; 15 (26%) TT]. The genotype frequencies did not deviate from the Hardy-Weinberg equilibrium. In the CC-positive group, concordance between both tests was 100%. In contrast, in the CC-negative group concordance was 95%, and positive BTH results could be attributed to other gastrointestinal pathologies in two patients. BTH had 100% negative predictive value, 88% positive predictive value, 100% sensitivity and 95% specificity, as compared to genetic testing. CONCLUSIONS: In carriers of the CC-genotype, BTH and genotyping correlate perfectly, and the genetic test provides an unambiguous result. In BTH-positive individuals with a negative genetic test there is good reason to suspect secondary causes of lactase deficiency.
BACKGROUND AND AIMS: Lactase non-persistence causes gastrointestinal symptoms after milk ingestion. Hydrogen breath test (BTH) and genotyping of a single nucleotide polymorphism (SNP) C >T 13,910 base pairs upstream of the lactase gene represent potential methods for diagnosis of this autosomal-recessive trait. The aim of the study was to compare the results of both tests in detecting lactose non-persistence in a tertiary referral centre. PATIENTS: A group of 58 patients admitted to a German university hospital for symptoms suggesting lactose intolerance. METHODS: BTH after lactose ingestion (50 g) and SNP -13,910C>T genotyping using single nucleotide primer extension (SNaPshot) technology (CC genotype--lactase non-persistence; TC/TT genotypes--lactase persistence). RESULTS: Overall, 17 (29%) patients had a positive and 41 (71%) had a negative BTH result; 15 (26%) patients were CC-positive and 43 (74%) were CC-negative [28 (48%) TC; 15 (26%) TT]. The genotype frequencies did not deviate from the Hardy-Weinberg equilibrium. In the CC-positive group, concordance between both tests was 100%. In contrast, in the CC-negative group concordance was 95%, and positive BTH results could be attributed to other gastrointestinal pathologies in two patients. BTH had 100% negative predictive value, 88% positive predictive value, 100% sensitivity and 95% specificity, as compared to genetic testing. CONCLUSIONS: In carriers of the CC-genotype, BTH and genotyping correlate perfectly, and the genetic test provides an unambiguous result. In BTH-positive individuals with a negative genetic test there is good reason to suspect secondary causes of lactase deficiency.
Authors: Jian-Feng Yang; Mark Fox; Hua Chu; Xia Zheng; Yan-Qin Long; Daniel Pohl; Michael Fried; Ning Dai Journal: World J Gastroenterol Date: 2015-06-28 Impact factor: 5.742
Authors: J Tomczonek-Moruś; A Wojtasik; K Zeman; B Smolarz; L Bąk-Romaniszyn Journal: United European Gastroenterol J Date: 2018-11-15 Impact factor: 4.623
Authors: Benjamin Misselwitz; Daniel Pohl; Heiko Frühauf; Michael Fried; Stephan R Vavricka; Mark Fox Journal: United European Gastroenterol J Date: 2013-06 Impact factor: 4.623