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Lactose intolerance: lack of evidence for short stature or vitamin D deficiency in prepubertal children.

ABSTRACT: BACKGROUND:The health consequences of lactose intolerance (LI) are unclear. AIMS:To investigate the effects of LI on stature and vitamin D status. 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 <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. RESULTS:There 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 <85(th) percentile) vs. overweight/obese (BMI ?85(th) 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. CONCLUSION:Short stature and vitamin D deficiency are not features of LI in prepubertal children.

SUBMITTER: Setty-Shah N

PROVIDER: S-EPMC3808302 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Lactose intolerance: lack of evidence for short stature or vitamin D deficiency in prepubertal children.

Setty-Shah Nithya N Maranda Louise L Candela Ninfa N Fong Jay J Dahod Idris I Rogol Alan D AD Nwosu Benjamin Udoka BU

PloS one 20131025 10

<h4>Background</h4>The health consequences of lactose intolerance (LI) are unclear.<h4>Aims</h4>To investigate the effects of LI on stature and vitamin D status.<h4>Hypotheses</h4>LI subjects will have similar heights and vitamin D status as controls.<h4>Subjects and methods</h4>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).<h4>Inclusion criteria</h4>p ...[more]

PMID: 24205288

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Project description:IntroductionThe growth hormone deficiency (GHD) diagnosis is controversial especially due to low specificity of growth hormone (GH) stimulation tests. It is therefore believed that children diagnosed with GHD form a heterogeneous group with growth disorder frequently independent on GH function. No study evaluating the complex etiology of growth failure in children with diagnosed GHD has been performed thus far.AimsTo discover genetic etiology of short stature in children with diagnosed GHD from families with short stature.MethodsFifty-two children diagnosed with primary GHD and vertically transmitted short stature (height SDS in the child and his/her shorter parent <-2 SD) were included to our study. The GHD diagnosis was based on growth data suggestive of GHD, absence of substantial disproportionality (sitting height to total height ratio <-2 SD or >+2 SD), IGF-1 levels <0 for age and sex specific SD and peak GH concentration <10 ug/L in two stimulation tests. All children were examined using next-generation sequencing methods, and the genetic variants were subsequently evaluated by American College of Medical Genetics standards and guidelines.ResultsThe age of children at enrollment into the study was 11 years (median, IQR 9-14 years), their height prior to GH treatment was -3.0 SD (-3.6 to -2.8 SD), IGF-1 concentration -1.4 SD (-2.0 to -1.1 SD), and maximal stimulated GH 6.3 ug/L (4.8-7.6 ug/L). No child had multiple pituitary hormone deficiency or a midbrain region pathology. Causative variant in a gene that affects growth was discovered in 15/52 (29%) children. Of them, only 2 (13%) had a genetic variant affecting GH secretion or function (GHSR and OTX2). Interestingly, in 10 (67%) children we discovered a primary growth plate disorder (ACAN, COL1A2, COL11A1, COL2A1, EXT2, FGFR3, NF1, NPR2, PTPN11 [2x]), in one (7%) a genetic variant impairing IGF-1 action (IGFALS) and in two (12%) a variant in miscellaneous genes (SALL4, MBTPS2).ConclusionsIn children with vertically transmitted short stature, genetic results frequently did not correspond with the clinical diagnosis of GH deficiency. These results underline the doubtful reliability of methods standardly used to diagnose GH deficiency.

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Lactose intolerance: lack of evidence for short stature or vitamin D deficiency in prepubertal children.

Publications

Lactose intolerance: lack of evidence for short stature or vitamin D deficiency in prepubertal children.

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