Abstract

BackgroundThe ability of adult humans to digest the milk sugar lactose - lactase persistence - is a dominant Mendelian trait that has been a subject of extensive genetic, medical and evolutionary research. Lactase persistence is common in people of European ancestry as well as some African, Middle Eastern and Southern Asian groups, but is rare or absent elsewhere in the world. The recent identification of independent nucleotide changes that are strongly associated with lactase persistence in different populations worldwide has led to the possibility of genetic tests for the trait. However, it is highly unlikely that all lactase persistence-associated variants are known. Using an extensive database of lactase persistence phenotype frequencies, together with information on how those data were collected and data on the frequencies of lactase persistence variants, we present a global summary of the extent to which current genetic knowledge can explain lactase persistence phenotype frequency.ResultsWe used surface interpolation of Old World lactase persistence genotype and phenotype frequency estimates obtained from all available literature and perform a comparison between predicted and observed trait frequencies in continuous space. By accommodating additional data on sample numbers and known false negative and false positive rates for the various lactase persistence phenotype tests (blood glucose and breath hydrogen), we also apply a Monte Carlo method to estimate the probability that known lactase persistence-associated allele frequencies can explain observed trait frequencies in different regions.ConclusionLactase persistence genotype data is currently insufficient to explain lactase persistence phenotype frequency in much of western and southern Africa, southeastern Europe, the Middle East and parts of central and southern Asia. We suggest that further studies of genetic variation in these regions should reveal additional nucleotide variants that are associated with lactase persistence.

Highlights

  • The ability of adult humans to digest the milk sugar lactose - lactase persistence - is a dominant Mendelian trait that has been a subject of extensive genetic, medical and evolutionary research

  • Lactase is necessary for the digestion of lactose, the main carbohydrate in milk [1], and without it, milk consumption can lead to bloating, flatulence, cramps and nausea [2]

  • In individuals who are not producing lactase, the undigested lactose will pass into the colon where it is fermented by various gut bacteria, producing fatty acids and various gases, hydrogen

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Summary

Introduction

The ability of adult humans to digest the milk sugar lactose - lactase persistence - is a dominant Mendelian trait that has been a subject of extensive genetic, medical and evolutionary research. The most frequently used non-invasive methods for identifying the presence of intestinal lactase are based upon detecting digestion products of lactose produced by the subject (Blood Glucose, BG) or gut bacteria (Breath Hydrogen, BH). For both methods a lactose load is administered to the subject following an overnight fast. Other non-invasive methods for detecting the presence/absence of lactase include assaying for urine galactose and detecting metabolites of Carbon-14-labelled lactose. This procedure is very rarely used for diagnosing healthy individuals because of its invasive nature [7]

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