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[PMID]:28233394
[Au] Autor:Wilder-Smith CH; Olesen SS; Materna A; Drewes AM
[Ad] Endereço:Brain-Gut Research Group, Gastroenterology Group Practice, Bern, Switzerland.
[Ti] Título:Predictors of response to a low-FODMAP diet in patients with functional gastrointestinal disorders and lactose or fructose intolerance.
[So] Source:Aliment Pharmacol Ther;45(8):1094-1106, 2017 Apr.
[Is] ISSN:1365-2036
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Diets low in fermentable sugars (low-FODMAP diets) are increasingly adopted by patients with functional gastrointestinal disorders (FGID), but outcome predictors are unclear. AIM: To identify factors predictive of an efficacious response to a low-FODMAP diet in FGID patients with fructose or lactose intolerance thereby gaining insights into underlying mechanisms. METHODS: Fructose and lactose breath tests were performed in FGID patients to determine intolerance (positive symptom score) and malabsorption (increased hydrogen or methane concentrations). Patients with fructose or lactose intolerance consumed a low-FODMAP diet and global adequate symptom relief was assessed after 6-8 weeks and correlated with pre-diet clinical symptoms and breath test results. RESULTS: A total of 81% of 584 patients completing the low-FODMAP diet achieved adequate relief, without significant differences between FGID subgroups or types of intolerance. Univariate analysis yielded predictive factors in fructose intolerance (chronic diarrhoea and pruritus, peak methane concentrations and fullness during breath tests) and lactose intolerance (peak hydrogen and methane concentrations and flatulence during breath tests). Using multivariate analysis, symptom relief was independently and positively predicted in fructose intolerance by chronic diarrhoea [odds ratio (95% confidence intervals): 2.62 (1.31-5.27), P = 0.007] and peak breath methane concentrations [1.53 (1.02-2.29), P = 0.042], and negatively predicted by chronic nausea [0.33 (0.16-0.67), P = 0.002]. No independent predictive factors emerged for lactose intolerance. CONCLUSIONS: Adequate global symptom relief was achieved with a low-FODMAP diet in a large majority of functional gastrointestinal disorders patients with fructose or lactose intolerance. Independent predictors of a satisfactory dietary outcome were only seen in fructose intolerant patients, and were indicative of changes in intestinal host or microbiome metabolism.
[Mh] Termos MeSH primário: Dieta com Restrição de Carboidratos
Intolerância à Frutose/dietoterapia
Gastroenteropatias/dietoterapia
Intolerância à Lactose/dietoterapia
[Mh] Termos MeSH secundário: Adulto
Testes Respiratórios
Metabolismo dos Carboidratos/fisiologia
Dieta/efeitos adversos
Feminino
Fermentação
Flatulência/etiologia
Flatulência/prevenção & controle
Frutose/análise
Frutose/metabolismo
Intolerância à Frutose/complicações
Intolerância à Frutose/diagnóstico
Intolerância à Frutose/metabolismo
Gastroenteropatias/complicações
Gastroenteropatias/diagnóstico
Gastroenteropatias/metabolismo
Seres Humanos
Lactose/análise
Lactose/metabolismo
Intolerância à Lactose/complicações
Intolerância à Lactose/diagnóstico
Intolerância à Lactose/metabolismo
Estudos Longitudinais
Masculino
Meia-Idade
Prognóstico
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
30237-26-4 (Fructose); J2B2A4N98G (Lactose)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE
[do] DOI:10.1111/apt.13978


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[PMID]:27797444
[Au] Autor:Ferreira CR; Devaney JM; Hofherr SE; Pollard LM; Cusmano-Ozog K
[Ad] Endereço:National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland.
[Ti] Título:Hereditary fructose intolerance mimicking a biochemical phenotype of mucolipidosis: A review of the literature of secondary causes of lysosomal enzyme activity elevation in serum.
[So] Source:Am J Med Genet A;173(2):501-509, 2017 Feb.
[Is] ISSN:1552-4833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We describe a patient with failure to thrive, hepatomegaly, liver dysfunction, and elevation of multiple plasma lysosomal enzyme activities mimicking mucolipidosis II or III, in whom a diagnosis of hereditary fructose intolerance (HFI) was ultimately obtained. She presented before introduction of solid foods, given her consumption of a fructose-containing infant formula. We present the most extensive panel of lysosomal enzyme activities reported to date in a patient with HFI, and propose that multiple enzyme elevations in plasma, especially when in conjunction with a normal plasma α-mannosidase activity, should elicit a differential diagnosis of HFI. We also performed a review of the literature on the different etiologies of elevated lysosomal enzyme activities in serum or plasma. © 2016 Wiley Periodicals, Inc.
[Mh] Termos MeSH primário: Intolerância à Frutose/diagnóstico
Mucolipidoses/diagnóstico
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Diagnóstico Diferencial
Ativação Enzimática
Feminino
Intolerância à Frutose/sangue
Intolerância à Frutose/genética
Seres Humanos
Lactente
Leucócitos/enzimologia
Lisossomos/enzimologia
Mucolipidoses/sangue
Mucolipidoses/genética
Fenótipo
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161101
[St] Status:MEDLINE
[do] DOI:10.1002/ajmg.a.38023


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[PMID]:27787351
[Au] Autor:Desai JR; Hyde CL; Kabadi S; St Louis M; Bonato V; Katrina Loomis A; Galaznik A; Berger ML
[Ad] Endereço:Pfizer Inc., New York, NY.
[Ti] Título:Utilization of Positive and Negative Controls to Examine Comorbid Associations in Observational Database Studies.
[So] Source:Med Care;55(3):244-251, 2017 Mar.
[Is] ISSN:1537-1948
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Opportunities to leverage observational data for precision medicine research are hampered by underlying sources of bias and paucity of methods to handle resulting uncertainty. We outline an approach to account for bias in identifying comorbid associations between 2 rare genetic disorders and type 2 diabetes (T2D) by applying a positive and negative control disease paradigm. RESEARCH DESIGN: Association between 10 common and 2 rare genetic disorders [Hereditary Fructose Intolerance (HFI) and α-1 antitrypsin deficiency] and T2D was compared with the association between T2D and 7 negative control diseases with no established relationship with T2D in 4 observational databases. Negative controls were used to estimate how much bias and variance existed in datasets when no effect should be observed. RESULTS: Unadjusted association for common and rare genetic disorders and T2D was positive and variable in magnitude and distribution in all 4 databases. However, association between negative controls and T2D was 200% greater than expected indicating the magnitude and confidence intervals for comorbid associations are sensitive to systematic bias. A meta-analysis using this method demonstrated a significant association between HFI and T2D but not for α-1 antitrypsin deficiency. CONCLUSIONS: For observational studies, when covariate data are limited or ambiguous, positive and negative controls provide a method to account for the broadest level of systematic bias, heterogeneity, and uncertainty. This provides greater confidence in assessing associations between diseases and comorbidities. Using this approach we were able to demonstrate an association between HFI and T2D. Leveraging real-world databases is a promising approach to identify and corroborate potential targets for precision medicine therapies.
[Mh] Termos MeSH primário: Comorbidade
Diabetes Mellitus Tipo 2/epidemiologia
Intolerância à Frutose/epidemiologia
Estudos Observacionais como Assunto/métodos
Deficiência de alfa 1-Antitripsina/epidemiologia
[Mh] Termos MeSH secundário: Bases de Dados Factuais
Seres Humanos
Projetos de Pesquisa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161028
[St] Status:MEDLINE
[do] DOI:10.1097/MLR.0000000000000640


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[PMID]:27716759
[Au] Autor:Sánchez-Ávila MT; Chávez Caraza KL; González Gil AM; Cantú Pompa JJ; Moreno Medrano E; Morales-Garza LA
[Ad] Endereço:Escuela de Medicina, Tecnológico de Monterrey. Monterrey, Nuevo León, México.
[Ti] Título:[Correlation between the presence and intensity of symptoms and the results of hydrogen breath tests in the diagnosis of carbohydrate intolerance].
[Ti] Título:Correlación entre los síntomas digestivos y los resultados de una prueba de hidrógeno en aliento en el diagnóstico de intolerancia a carbohidratos..
[So] Source:Rev Gastroenterol Peru;36(3):225-230, 2016 Jul-Sep.
[Is] ISSN:1609-722X
[Cp] País de publicação:Peru
[La] Idioma:spa
[Ab] Resumo:BACKGROUND: Hydrogen breath tests (HBT) are used to confirm the diagnosis of carbohydrate intolerance or small intestinal bacterial overgrowth (SIBO). OBJECTIVE: Determine the existence of a correlation between the presence and intensity of symptoms experimented by the patient after the ingestion of a carbohydrate load and the test result. MATERIALS AND METHODS: This is an observational, retrospective and analytic study, in which all patients' files from year 2008 to 2014 containing a report of a HBT performed at Hospital San José TEC de Monterrey were revised. Using a visual analogue scale (VAS), the patient reported the intensity of gastrointestinal symptoms during the test. Descriptive statistics were obtained, and exclusively for lactose HBTs, Pearson's correlation coefficient (r) between maximum hydrogen concentration in breath and symptom intensity was calculated. RESULTS: A HBT was performed in 33 patients: 23 with lactose, 5 with fructose, and 5 with lactulose as substrate. Of these, 10, 2, and 5 tests were positive, respectively. For lactose HBTs, the symptom with most sensitivity was flatulence (80%), which also had the greatest likelihood ratio for a positive test (1.73). Diarrhea had the greatest specificity (84.6%). A tendency for positivity was observed when patients presented symptoms. A moderately positive correlation between hydrogen ppm and symptom intensity was found (r=0.427, p=0.023). CONCLUSIONS: A correlation between symptom intensity and test positivity was found in patients with lactose intolerance. The presence of flatulence after lactose loading may be indicative of a positive test.
[Mh] Termos MeSH primário: Intolerância à Frutose/diagnóstico
Hidrogênio/metabolismo
Intolerância à Lactose/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Biomarcadores/metabolismo
Testes Respiratórios
Criança
Pré-Escolar
Feminino
Flatulência/etiologia
Intolerância à Frutose/metabolismo
Seres Humanos
Lactente
Intolerância à Lactose/metabolismo
Masculino
Meia-Idade
Estudos Retrospectivos
Sensibilidade e Especificidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Biomarkers); 7YNJ3PO35Z (Hydrogen)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161008
[St] Status:MEDLINE


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[PMID]:27254047
[Au] Autor:Yuce O; Kalayci AG; Comba A; Eren E; Caltepe G
[Ad] Endereço:Department of Pediatric Gastroenterology, Ondokuz Mayis University, Samsun, Turkey. Correspondence to: Dr Ozlem Yuce, Ondokuz Mayis University, Faculty of Medicine, Department of Pediatric Gastroenterology, Samsun, Turkey. ozlemkirmemis@gmail.com.
[Ti] Título:Lactose and Fructose Intolerance in Turkish Children with Chronic Abdominal Pain.
[So] Source:Indian Pediatr;53(5):394-7, 2016 May 08.
[Is] ISSN:0974-7559
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the prevalence of lactose and fructose intolerance in children with chronic abdominal pain. METHODS: Hydrogen breath tests were done to detect lactose and fructose malabsorption in 86 children with chronic abdominal pain (44 irritable bowel syndrome, 24 functional abdominal pain and 17 functional abdominal pain syndrome as per Rome III criteria) presenting to a Pediatric Gastroentreology department. RESULTS: 14 (16.3%) of patients were diagnosed with lactose intolerance and 11 (12.8%) with fructose intolerance. CONCLUSION: Lactose and fructose intolerance in children can lead to chronic abdominal pain and symptoms improve with dietary modifications.
[Mh] Termos MeSH primário: Dor Abdominal
Dor Crônica
Intolerância à Frutose
Intolerância à Lactose
[Mh] Termos MeSH secundário: Dor Abdominal/epidemiologia
Dor Abdominal/etiologia
Adolescente
Testes Respiratórios
Criança
Pré-Escolar
Dor Crônica/epidemiologia
Dor Crônica/etiologia
Feminino
Intolerância à Frutose/complicações
Intolerância à Frutose/epidemiologia
Seres Humanos
Intolerância à Lactose/complicações
Intolerância à Lactose/epidemiologia
Masculino
Turquia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160603
[St] Status:MEDLINE


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[PMID]:26770008
[Au] Autor:Macongonde EA; Vilela TC; Scaini G; Gonçalves CL; Ferreira BK; Costa NL; de Oliveira MR; Avila Junior S; Streck EL; Ferreira GC; Schuck PF
[Ad] Endereço:Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, Brazil.
[Ti] Título:Evaluation of the In Vivo and In Vitro Effects of Fructose on Respiratory Chain Complexes in Tissues of Young Rats.
[So] Source:Dis Markers;2015:312530, 2015.
[Is] ISSN:1875-8630
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hereditary fructose intolerance (HFI) is an autosomal-recessive disorder characterized by fructose and fructose-1-phosphate accumulation in tissues and biological fluids of patients. This disease results from a deficiency of aldolase B, which metabolizes fructose in the liver, kidney, and small intestine. We here investigated the effect of acute fructose administration on the activities of mitochondrial respiratory chain complexes, succinate dehydrogenase (SDH), and malate dehydrogenase (MDH) in cerebral cortex, liver, kidney, and skeletal muscle of male 30-day-old Wistar rats. The rats received subcutaneous injection of sodium chloride (0.9%; control group) or fructose solution (5 µmol/g; treated group). One hour later, the animals were euthanized and the cerebral cortex, liver, kidney, and skeletal muscle were isolated and homogenized for the investigations. Acute fructose administration increased complex I-III activity in liver. On the other hand, decreased complexes II and II-III activities in skeletal muscle and MDH in kidney were found. Interestingly, none of these parameters were affected in vitro. Our present data indicate that fructose administration elicits impairment of mitochondrial energy metabolism, which may contribute to the pathogenesis of the HFI patients.
[Mh] Termos MeSH primário: Intolerância à Frutose/metabolismo
Frutose/farmacologia
Malato Desidrogenase/metabolismo
Succinato Desidrogenase/metabolismo
[Mh] Termos MeSH secundário: Animais
Córtex Cerebral/metabolismo
Frutose/administração & dosagem
Rim/metabolismo
Fígado/metabolismo
Masculino
Músculo Esquelético
Ratos
Ratos Wistar
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
30237-26-4 (Fructose); EC 1.1.1.37 (Malate Dehydrogenase); EC 1.3.99.1 (Succinate Dehydrogenase)
[Em] Mês de entrada:1609
[Cu] Atualização por classe:160225
[Lr] Data última revisão:
160225
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160116
[St] Status:MEDLINE
[do] DOI:10.1155/2015/312530


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Texto completo SciELO Brasil
[PMID]:26312423
[Au] Autor:Macongonde EA; Costa NL; Ferreira BK; Biella MS; Frederico MJ; Oliveira MR; Ávila Júnior S; Silva FR; Ferreira GC; Streck EL; Schuck PF
[Ad] Endereço:Laboratório de Erros Inatos do Metabolismo, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, BR.
[Ti] Título:Neutrotoxic effects of fructose administration in rat brain: implications for fructosemia.
[So] Source:An Acad Bras Cienc;87(2 Suppl):1451-9, 2015 Aug.
[Is] ISSN:1678-2690
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Fructose accumulates in tissue and body fluids of patients affected by hereditary fructose intolerance (HFI), a disorder caused by the deficiency of aldolase B. We investigated the effect of acute fructose administration on the biochemical profile and on the activities of the Krebs cycle enzymes in the cerebral cortex of young rats. Rats received a subcutaneous injection of NaCl (0.9 %; control group) or fructose solution (5 µmol/g; treated group). Twelve or 24 h after the administration, the animals were euthanized and the cerebral cortices were isolated. Peripheral blood (to obtain the serum) and cerebral spinal fluid (CSF) from the animals were also collected. It was observed that albumin levels were decreased and cholesterol levels were increased in CSF of animals 12 h after the administration of fructose. In addition, serum lactate levels were increased 12 h after the administration, as compared to control group. Furthermore, malate dehydrogenase activity was increased in cerebral cortex from treated group 24 h after the administration of this carbohydrate. Herein we demonstrate that fructose administration alters biochemical parameters in CSF and serum and bioenergetics parameters in the cerebral cortex. These findings indicate a possible role of fructose on brain alterations found in HFI patients.
[Mh] Termos MeSH primário: Córtex Cerebral/efeitos dos fármacos
Intolerância à Frutose/metabolismo
Frutose/farmacologia
[Mh] Termos MeSH secundário: Animais
Córtex Cerebral/metabolismo
Modelos Animais de Doenças
Frutose/metabolismo
Masculino
Ratos
Ratos Wistar
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
30237-26-4 (Fructose)
[Em] Mês de entrada:1605
[Cu] Atualização por classe:150924
[Lr] Data última revisão:
150924
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150828
[St] Status:MEDLINE


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[PMID]:26138365
[Au] Autor:Enko D; Kriegshäuser G; Kimbacher C; Stolba R; Mangge H; Halwachs-Baumann G
[Ad] Endereço:Institute of Laboratory Medicine, General Hospital Steyr, Steyr, Austria.
[Ti] Título:Carbohydrate Malabsorption and Putative Carbohydrate-Specific Small Intestinal Bacterial Overgrowth: Prevalence and Diagnostic Overlap Observed in an Austrian Outpatient Center.
[So] Source:Digestion;92(1):32-8, 2015.
[Is] ISSN:1421-9867
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIMS: While lactose malabsorption is a well-investigated condition, few epidemiologic data are available for fructose and sorbitol malabsorption. The aim of this study was to assess the prevalence rates for primary lactose malabsorption, fructose and sorbitol malabsorption, and carbohydrate-specific small intestinal bacterial overgrowth (cs-SIBO) in an Austrian outpatient center. METHODS: In total, 306 adult patients, who were primarily referred with suspected carbohydrate malabsorption by general practitioners to our outpatient clinic, underwent genetic testing (C/T-13910 polymorphism) for primary lactose malabsorption, and a combined hydrogen (H2)/methane (CH4) breath test for fructose (25 g) and sorbitol (12.5 g) malabsorption. Cohen's kappa (κ) was calculated for agreement between positive breath test results and self-reported symptoms during the test. RESULTS: Seventy-eight (25.49%) patients were C/C-13910 homozygotes, indicating primary lactose malabsorption. Thirty-four (11.11%) and 57 (18.63%) patients were classified as fructose and sorbitol malabsorbers. Cohen's κ measuring agreements between positive fructose and sorbitol breath test results and self-reported symptoms during the test were 0.33 and 0.49, respectively. Twenty-nine (9.50%) patients with an early H2/CH4 peak (i.e. within 60 minutes after fructose and/or sorbitol ingestion) were diagnosed with cs-SIBO. CONCLUSION: In Austria, carbohydrate malabsorption is a frequent condition in patients referred by general practitioners to carbohydrate malabsorption testing.
[Mh] Termos MeSH primário: Frutose/metabolismo
Síndromes de Malabsorção/epidemiologia
Sorbitol/metabolismo
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Instituições de Assistência Ambulatorial/estatística & dados numéricos
Áustria/epidemiologia
Síndrome da Alça Cega/epidemiologia
Síndrome da Alça Cega/genética
Síndrome da Alça Cega/metabolismo
Testes Respiratórios/métodos
Feminino
Intolerância à Frutose/epidemiologia
Intolerância à Frutose/genética
Homozigoto
Seres Humanos
Hidrogênio
Intolerância à Lactose/epidemiologia
Intolerância à Lactose/genética
Síndromes de Malabsorção/genética
Síndromes de Malabsorção/metabolismo
Masculino
Metano
Meia-Idade
Prevalência
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
30237-26-4 (Fructose); 506T60A25R (Sorbitol); 7YNJ3PO35Z (Hydrogen); OP0UW79H66 (Methane)
[Em] Mês de entrada:1604
[Cu] Atualização por classe:150803
[Lr] Data última revisão:
150803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150704
[St] Status:MEDLINE
[do] DOI:10.1159/000430981


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[PMID]:25987795
[Au] Autor:Berg LK; Fagerli E; Myhre AO; Florholmen J; Goll R
[Ad] Endereço:Leif Kyrre Berg, Erik Fagerli, Department of Medicine, Hospital of Helgeland, 8613 Nordland, Norway.
[Ti] Título:Self-reported dietary fructose intolerance in irritable bowel syndrome: Proposed diagnostic criteria.
[So] Source:World J Gastroenterol;21(18):5677-84, 2015 May 14.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: To study the criteria for self-reported dietary fructose intolerance (DFI) and to evaluate subjective global assessment (SGA) as outcome measure. METHODS: Irritable bowel syndrome (IBS) patients were randomized in an open study design with a 2 wk run-in on a habitual IBS diet, followed by 12 wk with/without additional fructose-reduced diet (FRD). Daily registrations of stool frequency and consistency, and symptoms on a visual analog scale (VAS) were performed during the first 4 wk. SGA was used for weekly registrations during the whole study period. Provocation with high-fructose diet was done at the end of the registration period. Fructose breath tests (FBTs) were performed. A total of 182 subjects performed the study according to the protocol (88 FRD, 94 controls). RESULTS: We propose a new clinically feasible diagnostic standard for self-reported fructose intolerance. The instrument is based on VAS registrations of symptom relief on FRD combined with symptom aggravation upon provocation with fructose-rich diet. Using these criteria 43 of 77 patients (56%) in the present cohort of IBS patients had self-reported DFI. To improve the concept for clinical evaluation, we translated the SGA scale instrument to Norwegian and validated it in the context of the IBS diet regimen. The validation procedures showed a sensitivity, specificity and κ value for SGA detecting the self-reported DFI group by FRD response within the IBS patients of 0.79, 0.75 and 0.53, respectively. Addition of the provocation test yielded values of 0.84, 0.76 and 0.61, respectively. The corresponding validation results for FBT were 0.57, 0.34 and -0.13, respectively. CONCLUSION: FRD improves symptoms in a subgroup of IBS patients. A diet trial followed by a provocation test evaluated by SGA can identify most responders to FRD.
[Mh] Termos MeSH primário: Intolerância à Frutose/diagnóstico
Síndrome do Intestino Irritável/diagnóstico
Autorrelato
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Testes Respiratórios
Dieta com Restrição de Carboidratos
Estudos de Viabilidade
Feminino
Intolerância à Frutose/dietoterapia
Intolerância à Frutose/epidemiologia
Seres Humanos
Síndrome do Intestino Irritável/dietoterapia
Síndrome do Intestino Irritável/epidemiologia
Masculino
Meia-Idade
Noruega/epidemiologia
Valor Preditivo dos Testes
Prevalência
Reprodutibilidade dos Testes
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1604
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150520
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v21.i18.5677


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[PMID]:25919770
[Au] Autor:Bonfrate L; Krawczyk M; Lembo A; Grattagliano I; Lammert F; Portincasa P
[Ad] Endereço:aDepartment of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", Policlinico Hospital, University of Bari Medical School, Bari, Italy bDepartment of Medicine II, Saarland University Medical Center, Homburg, Germany cLaboratory of Metabolic Liver Diseases, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland dDepartment of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA eItalian College of General Practitioners, Florence, Italy.
[Ti] Título:Effects of dietary education, followed by a tailored fructose-restricted diet in adults with fructose malabsorption.
[So] Source:Eur J Gastroenterol Hepatol;27(7):785-96, 2015 Jul.
[Is] ISSN:1473-5687
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Fructose is absorbed by GLUT transporters in the small intestine. If this process is inadequate, abdominal symptoms because of fructose intolerance may arise. The effect of a tailored fructose-restricted diet on gastrointestinal complaints was assessed in patients with fructose intolerance. MATERIALS AND METHODS: Following an abnormal fructose breath test (50 g), 107 patients (64 also with lactose intolerance) entered three study periods: weeks 0-32 (free diet), weeks 32-36 (progressive increasing amount of fructose up to quantity inducing symptoms, 'trigger dose'), and weeks 36-48 (tailored fructose-restricted diet according to the 'trigger dose'). A subgroup of 15 patients underwent additional fructose breath tests (35, 25 g) to compare three different doses. RESULTS: At baseline, the most frequent symptoms were bloating and abdominal pain, and were more severe with combined fructose and lactose intolerance. During the free diet, patients reported eliminating (48%) or reducing (52%) fructose-containing foods, with a significant improvement in symptoms (abdominal pain from 79.7 ± 1.3 to 19.3 ± 1.8 mm; bloating from 83.1 ± 1.3 to 19.4 ± 1.8 mm; number of evacuations/day from 3.9 ± 0.16 to 1.1 ± 0.04; Bristol score from 5.1 ± 0.14 to 3.8 ± 0.1, P < 0.00001). During the tailored fructose-restricted diet, the consistent improvement in symptoms persisted and was similar to the improvement on free diet (abdominal pain 23.6 ± 1.9 mm; bloating 19.4 ± 1.8 mm; number of evacuations/day 1.7 ± 0.07; Bristol score 3.5 ± 0.06, P<0.00001 vs. baseline). A dose-dependent effect of fructose was observed on symptoms during the fructose breath test. CONCLUSION: In our setting, individuals with fructose intolerance show an inappropriate dietary self-management. By contrast, a tailored fructose-restricted diet improves gastrointestinal symptoms without senseless food deprivation.
[Mh] Termos MeSH primário: Testes Respiratórios
Intolerância à Frutose/dietoterapia
Intolerância à Frutose/diagnóstico
Frutose/administração & dosagem
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Adulto
Testes Respiratórios/métodos
Estudos de Coortes
Feminino
Flatulência/etiologia
Seguimentos
Frutose/metabolismo
Intolerância à Frutose/complicações
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Autocuidado
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
30237-26-4 (Fructose)
[Em] Mês de entrada:1603
[Cu] Atualização por classe:150604
[Lr] Data última revisão:
150604
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150429
[St] Status:MEDLINE
[do] DOI:10.1097/MEG.0000000000000374



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