title: Fructose malabsorption may be gender dependent and fails to show compensation by colonic adaptation.
abstract: Fructose malabsorption is linked to gastrointestinal and other unusual symptoms. Polymers of fructose are also recognized prebiotics. While some prebiotics can self-adapt when consumed regularly (resulting in decreased breath hydrogen and symptoms), we wondered whether self-adaptation occurs with basic fructose. We evaluated 90 subjects (61 females). Each completed a diet questionnaire and underwent a fructose challenge. Breath hydrogen and quantified symptom scores were recorded. Group comparisons for sum of breath hydrogen and total symptom scores were evaluated with the Mann-Whitney U test. Spearman's correlation coefficient and chi(2) or Fisher's exact test were used as appropriate. Malabsorption occurred in 29 patients (32.2%) and low-grade symptoms without malabsorption in 30 (33%). Women complained of symptoms more frequently (p = 0.04) and exhibited more fructose malabsorption (p = 0.0527). Breath hydrogen correlated with symptoms (r = 0.516, p = 0.0037). Adaptation with increasing pretest fructose intake was absent. We conclude that gender may influence fructose malabsorption and there is no adaptation to regular consumption.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada. aszilagy@gas.jgh.mcgill.ca
authors.forename: Andrew
authors.initials: A
authors.lastname: Szilagyi
authors.forename: Paula
authors.initials: P
authors.lastname: Malolepszy
authors.forename: Samara
authors.initials: S
authors.lastname: Yesovitch
authors.forename: Christina
authors.initials: C
authors.lastname: Vinokuroff
authors.forename: Usha
authors.initials: U
authors.lastname: Nathwani
authors.forename: Albert
authors.initials: A
authors.lastname: Cohen
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Xue
mesh_terms: D000220:Adaptation, Biological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000378:metabolism*; D004040:Dietary Carbohydrates; D005260:Female; D005500:Follow-Up Studies; D005632:Fructose / Q000493:pharmacokinetics*; D005633:Fructose Intolerance / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013549:Sweetening Agents / Q000493:pharmacokinetics*
chemical_list: D004040:Dietary Carbohydrates; D013549:Sweetening Agents; D005632:Fructose