[Intra-digestive fermentation in intestinal malabsorption syndromes: relations with elevated serum activity of gamma-glutamyl-transpeptidase].
The aim of this prospective study was to examine the relationship between gastrointestinal ethanol production ("Mei-Tei-Sho" syndrome described in Japan) and biological liver dysfunction associated with intestinal malabsorption syndromes.


METHODS
Sixty-five patients with malabsorption-diarrhea underwent 98 simultaneous measurements of plasma gamma-glutamyl-transpeptidase and of faecal ethanol concentrations; in 5 cases, ethanolemia and faecal ethanol concentrations were measured after a 250 g rice-meal; in 1, ethanol concentration was measured in a sample of caecal liquid in hours following local instillation of fructose (40 g).


RESULTS
Faecal ethanol was detected at least once in 60/65 patients (74/98 measurements, maximum 3.50 g*L-1), more often (98.0%, P < 0.001) in 51 patients with gamma-glutamyl-transpeptidase above 38 IU/L. Eating rice increased the faecal ethanol concentration in 5 patients, 2 of whom had measurable ethanolemia (0.20 and 0.47 g*L-1). Ileo-caecal ethanol concentration following local fructose instillation was 11.8 g*L-1.


CONCLUSIONS
Endogenous gastrointestinal ethanol production contributes to elevated gamma-glutamyl-transpeptidase activity observed during malabsorption syndromes.
Picot
D
D
Centre de Réadaptation Digestive et Nutritionnelle et de Réadaptation Cardio-vasculaire, Clinique Saint-Yves, Rennes.
Lauvin
R
R
Hellegouarc'h
R
R
D000328:Adult; D000431:Ethanol / Q000378:metabolism; D005243:Feces / Q000737:chemistry; D005260:Female; D005285:Fermentation; D006801:Humans; D008107:Liver Diseases / Q000209:etiology; D008111:Liver Function Tests; D008286:Malabsorption Syndromes / Q000201:enzymology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D005723:gamma-Glutamyltransferase / Q000097:blood*
D000431:Ethanol; D005723:gamma-Glutamyltransferase
Fermentation intra-digestive au cours des syndromes de malabsorption intestinale: relations avec l'augmentation de l'activité sérique de la gamma-glutamyl-transpeptidase.