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Disaccharidase activities in children: normal values and comparison based on symptoms and histologic changes.
J Pediatr Gastroenterol Nutr. 1999 Mar; 28(3):246-51.JP

Abstract

BACKGROUND

The relationship between symptoms, intestinal mucosal histology, and disaccharidase activities is not well defined. An analysis of disaccharidase activities was performed in children grouped by age, symptoms, and intestinal mucosal histology and normal values established.

METHODS

Disaccharidase activities and histology of 246 endoscopically obtained duodenal biopsies in 232 patients (121 girls; age range, 0.08-17 years; mean, 5.9 years) in a 3-year period were reviewed. Patients were divided into two groups based on absence (group 1; n = 142) or presence (group 2; n = 90) of diarrhea and were subdivided by age into, less than 24 months of age and 24 months of age or more. Histologic changes within groups were classified as (A) normal, (B) mild, or (C) moderate to severe based on villus height abnormalities. A questionnaire was sent to 34 patients with hypolactasia to assess the efficacy of lactose avoidance and/or lactase supplementation.

RESULTS

All group 1 patients had normal findings in analysis of mucosal specimens, and their disaccharidase activities showed normal values because they had no diarrhea. The geometric means (95% confidence interval) in children aged less than 24 months are (in micromoles of substrate hydrolyzed per minute at 37 degrees C per gram protein) (units [U]) lactase, 36.7 (13.4-100.4); maltase, 178.5 (88.9-356.3); palatinase, 12.7 (3.8-41.5); and sucrase 60.0 (24.0-148.1). In children 24 months of age or more, the values are 23.2 (3.9-108.1), 167.6 (78.8-355.9), 12.7 (4.9-32.9), and 51.0 (20.5-126.0), respectively. Only lactase activity decreased with age (p < 0.05). No differences in disaccharidase activities were noted in patients with and without diarrhea if the mucosal histology was normal (group 1A vs. 2A). In patients with diarrhea, values were commensurate with the degree of mucosal injury, especially in the older group. Twenty-two of 27 patients (81%) who responded to the questionnaire had benefited from lactase supplementation and/or lactose avoidance.

CONCLUSIONS

We have established normal values for disaccharidase activities in the pediatric population. Although the disaccharidase activities correlate more with degree of intestinal mucosal injury than with symptoms, their activities are difficult to predict accurately based on these criteria. If required, disaccharidase activities should be measured biochemically.

Authors+Show Affiliations

Division of Pediatric Gastroenterology, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis 46202-5225, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10067723

Citation

Gupta, S K., et al. "Disaccharidase Activities in Children: Normal Values and Comparison Based On Symptoms and Histologic Changes." Journal of Pediatric Gastroenterology and Nutrition, vol. 28, no. 3, 1999, pp. 246-51.
Gupta SK, Chong SK, Fitzgerald JF. Disaccharidase activities in children: normal values and comparison based on symptoms and histologic changes. J Pediatr Gastroenterol Nutr. 1999;28(3):246-51.
Gupta, S. K., Chong, S. K., & Fitzgerald, J. F. (1999). Disaccharidase activities in children: normal values and comparison based on symptoms and histologic changes. Journal of Pediatric Gastroenterology and Nutrition, 28(3), 246-51.
Gupta SK, Chong SK, Fitzgerald JF. Disaccharidase Activities in Children: Normal Values and Comparison Based On Symptoms and Histologic Changes. J Pediatr Gastroenterol Nutr. 1999;28(3):246-51. PubMed PMID: 10067723.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disaccharidase activities in children: normal values and comparison based on symptoms and histologic changes. AU - Gupta,S K, AU - Chong,S K, AU - Fitzgerald,J F, PY - 1999/3/6/pubmed PY - 1999/3/6/medline PY - 1999/3/6/entrez SP - 246 EP - 51 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 28 IS - 3 N2 - BACKGROUND: The relationship between symptoms, intestinal mucosal histology, and disaccharidase activities is not well defined. An analysis of disaccharidase activities was performed in children grouped by age, symptoms, and intestinal mucosal histology and normal values established. METHODS: Disaccharidase activities and histology of 246 endoscopically obtained duodenal biopsies in 232 patients (121 girls; age range, 0.08-17 years; mean, 5.9 years) in a 3-year period were reviewed. Patients were divided into two groups based on absence (group 1; n = 142) or presence (group 2; n = 90) of diarrhea and were subdivided by age into, less than 24 months of age and 24 months of age or more. Histologic changes within groups were classified as (A) normal, (B) mild, or (C) moderate to severe based on villus height abnormalities. A questionnaire was sent to 34 patients with hypolactasia to assess the efficacy of lactose avoidance and/or lactase supplementation. RESULTS: All group 1 patients had normal findings in analysis of mucosal specimens, and their disaccharidase activities showed normal values because they had no diarrhea. The geometric means (95% confidence interval) in children aged less than 24 months are (in micromoles of substrate hydrolyzed per minute at 37 degrees C per gram protein) (units [U]) lactase, 36.7 (13.4-100.4); maltase, 178.5 (88.9-356.3); palatinase, 12.7 (3.8-41.5); and sucrase 60.0 (24.0-148.1). In children 24 months of age or more, the values are 23.2 (3.9-108.1), 167.6 (78.8-355.9), 12.7 (4.9-32.9), and 51.0 (20.5-126.0), respectively. Only lactase activity decreased with age (p < 0.05). No differences in disaccharidase activities were noted in patients with and without diarrhea if the mucosal histology was normal (group 1A vs. 2A). In patients with diarrhea, values were commensurate with the degree of mucosal injury, especially in the older group. Twenty-two of 27 patients (81%) who responded to the questionnaire had benefited from lactase supplementation and/or lactose avoidance. CONCLUSIONS: We have established normal values for disaccharidase activities in the pediatric population. Although the disaccharidase activities correlate more with degree of intestinal mucosal injury than with symptoms, their activities are difficult to predict accurately based on these criteria. If required, disaccharidase activities should be measured biochemically. SN - 0277-2116 UR - https://www.unboundmedicine.com/medline/citation/10067723/Disaccharidase_activities_in_children:_normal_values_and_comparison_based_on_symptoms_and_histologic_changes_ L2 - http://dx.doi.org/10.1097/00005176-199903000-00007 DB - PRIME DP - Unbound Medicine ER -