title: Lactose malabsorption is a risk factor for decreased bone mineral density in pancreatic insufficient cystic fibrosis patients.
abstract: As decreased bone mineral density (BMD) is a common problem in cystic fibrosis (CF) and milk products may have pivotal dietary role affecting BMD, we aimed to assess the potential influence of adult-type hypolactasia (ATH) and lactose malabsorption (LM) on BMD in adolescent and young adult patients. In 95 CF pancreatic-insufficient patients aged 10-25 years (without liver cirrhosis, steatosis and cholestasis, diabetes mellitus, systemic glucocorticoid therapy), lumbar BMD, the nutritional status, pulmonary function, vitamin D3 concentration, calcium intake and single-nucleotide polymorphism upstream of the lactase gene were assessed. In subjects with the -13910 C/C genotype predisposing to ATH, the presence of LM was determined with the use of a hydrogen-methane breath test (BT). BMD and calcium intake were significantly lower in patients with the C/C genotype (P<0.028 and P<0.043, respectively). The abnormal BMD was stated more frequently in patients with the C/C genotype (P<0.042) and with LM (P<0.007). BMD, daily calcium intake and serum vitamin D concentration were significantly lower in LM subjects than in the other patients (P<0.037, P<0.000004 and P<0.0038, respectively). In logistic regression analysis, the relationship between examined parameters and BMD, was found to be statistically significant (P<0.001). However, only standardized body weight and LM were documented to influence BMD (P<0.025 and P<0.044, respectively). In conclusion, LM seems to be an independent risk factor for decreased BMD in CF patients.
authors.affiliation: Department of Physiology, Poznań University of Medical Sciences, Szpitalna 27/33,Poznań, Poland.
authors.forename: Edyta
authors.initials: E
authors.lastname: Mądry
authors.forename: Beata
authors.initials: B
authors.lastname: Krasińska
authors.forename: Sławomira
authors.initials: S
authors.lastname: Drzymała-Czyż
authors.forename: Dorota
authors.initials: D
authors.lastname: Sands
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Lisowska
authors.forename: Philip
authors.initials: P
authors.lastname: Grebowiec
authors.forename: Alina
authors.initials: A
authors.lastname: Minarowska
authors.forename: Beata
authors.initials: B
authors.lastname: Oralewska
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Mańkowski
authors.forename: Jerzy
authors.initials: J
authors.lastname: Moczko
authors.forename: Jarosław
authors.initials: J
authors.lastname: Walkowiak
mesh_terms: D000328:Adult; D001835:Body Weight; D018488:Bone Demineralization, Pathologic / Q000209:etiology* / Q000235:genetics; D015519:Bone Density / Q000235:genetics*; D001944:Breath Tests; D002118:Calcium / Q000378:metabolism; D002648:Child; D002762:Cholecalciferol / Q000097:blood; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D006801:Humans; D043322:Lactase / Q000172:deficiency / Q000235:genetics; D007787:Lactose Intolerance / Q000150:complications / Q000235:genetics*; D008297:Male; D020641:Polymorphism, Single Nucleotide; D011401:Promoter Regions, Genetic / Q000235:genetics; D012307:Risk Factors
chemical_list: D002762:Cholecalciferol; D043322:Lactase; D002118:Calcium