title: Intestinal disaccharidase activity in patients with autism: effect of age, gender, and intestinal inflammation.
abstract: Intestinal disaccharidase activities were measured in 199 individuals with autism to determine the frequency of enzyme deficiency. All patients had duodenal biopsies that were evaluated morphologically and assayed for lactase, sucrase, and maltase activity. Frequency of lactase deficiency was 58% in autistic children ≤ 5 years old and 65% in older patients. As would be expected, patients with autism at age 5 > years demonstrated significant decline in lactase activity (24%, p = .02) in comparison with ≤ 5 years old autistic patients. Boys ≤ 5 years old with autism had 1.7 fold lower lactase activity than girls with autism (p = .02). Only 6% of autistic patients had intestinal inflammation. Lactase deficiency not associated with intestinal inflammation or injury is common in autistic children and may contribute to abdominal discomfort, pain and observed aberrant behavior. Most autistic children with lactose intolerance are not identified by clinical history.
authors.affiliation: Harvard Medical School, Boston, MA, USA. kushak.rafail@mgh.harvard.edu
authors.forename: Rafail I
authors.initials: RI
authors.lastname: Kushak
authors.forename: Gregory Y
authors.initials: GY
authors.lastname: Lauwers
authors.forename: Harland S
authors.initials: HS
authors.lastname: Winter
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Buie
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001321:Autistic Disorder / Q000201:enzymology* / Q000453:epidemiology / Q000473:pathology*; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004386:Duodenum / Q000201:enzymology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000201:enzymology* / Q000453:epidemiology / Q000473:pathology*; D007413:Intestinal Mucosa / Q000201:enzymology* / Q000473:pathology*; D043322:Lactase / Q000378:metabolism*; D007787:Lactose Intolerance / Q000201:enzymology* / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D012016:Reference Values; D012189:Retrospective Studies; D013393:Sucrase / Q000378:metabolism*; D055815:Young Adult; D000520:alpha-Glucosidases / Q000378:metabolism*
chemical_list: D043322:Lactase; D000520:alpha-Glucosidases; D013393:Sucrase