Lactose maldigestion in the formation of insulin resistance in obese children with various lactase gene genotypes and methods of treatment
Journal Title: Гастроентерологія - Year 2018, Vol 52, Issue 1
Abstract
Background. In recent year, the occurrence of obesity and its complicated course increases with epidemic speed, especially among children living in large cities, and the causes of this pathomorphosis remain understudied. In particular, the role of lactose maldigestion in the formation of insulin resistance associated with obesity in children is not described. The objective was to study the association of lactose maldigestion with lactase gene genotypes in obese children, to investigate the effectiveness of treatment for obesity using low-lactose diet and exogenous lactase preparation. Materials and methods. Genotyping by the polymorphic locus of the lactase gene was carried out using real-time polymerase chain reaction, and the state of lactose digestion by hydrogen breath test (HBT) was determined in 74 obese children and 16 healthy children aged 6–18 years. Observation groups were formed following genotyping, НВT and prescribed therapy. Group I consisted of 11 children with C/C 13910 genotype and lactose maldigestion receiving exogenous lactase preparation from the first day of treatment. Group II included 11 children with C/C 13910 genotype and lactose maldigestion, who received low-lactose diet. Group III consisted of 11 children with C/C 13910 genotype and lactose maldigestion receiving only standard therapy according to the national treatment protocols, and group IV — 11 children with C/T 13910 genotype and lactose maldigestion, who received low-lactose diet. In addition, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used in children from the observation groups before and after various treatments. Results. For obesity in children, the average level of hydrogen concentration during HBT after lactose load in C/C 13910 genotype was (36.05 ± 4.73) ppm, in C/T 13910 genotype— (22.61 ± 4.10) ppm, in T/T 13910 genotype — (1.33 ± 0.63) ppm, and in healthy children with C/C 13910 genotype — (13.91 ± 3.75) ppm, p < 0.05. The highest level of hydrogen concentration in the exhaled air with HBT before treatment was registered in group I and was (39.40 ± 8.04) ppm, compared to (32.70 ± 10.48) ppm in group II (p > 0.05), in group III — (8.60 ± 1.16) ppm (р < 0.05), in group IV — (26.30 ± 4.91) ppm (р < 0.05). The highest HOMA-IR before treatment was also registered in observation group I and was (7.33 ± 0.38); in group II — (5.53 ± 0.70); in group ІІІ — (4.98 ± 0.76); in group IV — (4.85 ± 0.77) (p < 0.05). The value of HOMA-IR after treatment had a statistically significant decrease in groups I and II and was (3.96 ± 0.60) and (3.17 ± 0.35), respectively (p < 0.05). Conclusions. Lactose maldigestion increases insulin resistance in obese children and is associated with C/C 13910 genotype, p < 0.05. Treatment of lactose maldigestion in obese children with C/C 13910 genotype using exogenous lactase preparation or low-lactose diet with the help of our computer program “Low-lactose diet” has the same efficacy and affects statistically significant decrease in HOMA-IR.
Authors and Affiliations
A. E. Abaturov, Yu. M. Stepanov, A. A. Nikulina
Keywords
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- EP ID EP290796
- DOI 10.22141/2308-2097.52.1.2018.130775
- Views 90
- Downloads 0
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