Lactose Intolerance: Lack of Evidence for Short Stature or Vitamin D Deficiency in Prepubertal Children

Nithya Setty-Shah,Benjamin Udoka Nwosu,Idris Dahod,Alan D Rogol,Ninfa Candela,Jay Fong,Louise Maranda,Andrea S Wiley

doi:10.1371/journal.pone.0078653

Nithya Setty-Shah, Benjamin Udoka Nwosu + Show 6 more

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https://doi.org/10.1371/journal.pone.0078653

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Abstract

ABSTRACTBackgroundThe health consequences of lactose intolerance (LI) are unclear.AimsTo investigate the effects of LI on stature and vitamin D status.HypothesesLI subjects will have similar heights and vitamin D status as controls.Subjects and MethodsPrepubertal children of ages 3-12 years with LI (n=38, age 8.61 ± 3.08y, male/female 19/19) were compared to healthy, age- and gender-matched controls (n=49, age 7.95±2.64, male/female 28/21). Inclusion criteria: prepubertal status (boys: testicular volume <3cc; girls: Tanner 1 breasts), diagnosis of LI by hydrogen breath test, and no history of calcium or vitamin D supplementation. Vitamin D deficiency was defined as 25-hydroxyvitamin D [25(OH)D] <50 nmol/L. Gender-adjusted midparental target height (MPTH) z-score was calculated using NCHS data for 18 year-old adults. Data were expressed as mean ± SD.ResultsThere was no significant difference in 25(OH)D between the LI and non-LI subjects (60.1±21.1, vs. 65.4 ± 26.1 nmol/L, p = 0.29). Upon stratification into normal weight (BMI <85th percentile) vs. overweight/obese (BMI ≥85th percentile), the normal weight controls had significantly higher 25(OH)D level than both the normal weight LI children (78.3 ± 32.6 vs. 62.9 ± 23.2, p = 0.025), and the overweight/obese LI children (78.3±32.6 vs. 55.3±16.5, p = 0.004). Secondly, there was no overall difference in height z-score between the LI children and controls. The normal weight LI patients had similar height as normal controls (-0.46 ± 0.89 vs. -0.71 ± 1.67, p = 0.53), while the overweight/obese LI group was taller than the normal weight controls (0.36 ± 1.41 vs. -0.71 ± 1.67, p = 0.049), and of similar height as the overweight/obese controls (0.36 ± 1.41 vs. 0.87 ± 1.45, p = 0.28). MPTH z-score was similar between the groups.ConclusionShort stature and vitamin D deficiency are not features of LI in prepubertal children.

Highlights

There is no consensus on the health consequences of lactose intolerance (LI)[1,2]
The degree of elevation of these gases as measured by the hydrogen breath test forms the basis of the clinical diagnosis of LI[4]
There were no significant differences in height zscore, midparental target height (MPTH) z-score, or 25(OH)D level between the subjects and controls. 25: hydroxyvitmin D The normal weight controls had significantly higher 25(OH)D

Summary

Introduction

There is no consensus on the health consequences of lactose intolerance (LI)[1,2]. The commonest form of LI, primary LI, results from either a genetic inability to produce lactase, an enzyme that breaks down lactose to glucose and galactose, or from an age-related down-regulation of lactase production[3]. A central hypothesis in LI is that dairy avoidance leads to reduced intake of protein and calcium, which results in poor growth, short stature and low bone mineral density, respectively [6]. Hypotheses: LI subjects will have similar heights and vitamin D status as controls. Subjects and Methods: Prepubertal children of ages 3-12 years with LI (n=38, age 8.61 ± 3.08y, male/female 19/19) were compared to healthy, age- and gender-matched controls (n=49, age 7.95±2.64, male/female 28/21). Inclusion criteria: prepubertal status (boys: testicular volume

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