Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Minerals, trace elements, Vit. D and bone health

Assessment of vitamin D status and serum CrossLaps levels in adults with primary lactose malabsorption

Abstract

Background/Objectives:

Primary adult-type lactose malabsorption (PALM) is a widespread inherited autosomal recessive condition, which is considered to be associated with osteoporosis. This prospective study aimed at assessing the 25-hydroxy-vitamin D (25(OH)D) status and serum CrossLaps levels in individuals with PALM and normal controls.

Subjects/Methods:

All participants (n=210) underwent genotyping for the LCT C/T-13910 polymorphism, 25(OH)D and CrossLaps measurements and clinical examinations. In addition, the anthropometric data (that is, height, weight and body mass index) were determined.

Results:

Fifty-five individuals with PALM (that is, LCT C/C-13910 homozygotes) showed lower 25(OH)D (mean: 24.95±10.04 vs 28.59±9.56 ng/ml, P=0.018) and higher CrossLaps serum levels (mean: 0.46±0.31 vs 0.43±0.49 ng/ml, P=0.251) compared with 155 normal controls (that is, LCT C/T-13910 hetero- or T/T-13910 homozygotes). Anthropometric data were similar between PALM probands and controls.

Conclusions:

Individuals with PALM were found to have lower 25(OH)D and higher CrossLaps serum levels compared with normal controls. In order to preserve life-long bone health, routine 25(OH)D and CrossLaps serum measurements should be performed in individuals with PALM.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Usai-Satta P, Scarpa M, Oppia F, Cabras F . Lactose malabsorption and intolerance: what should be the best clinical management? World J Gastrointest Pharmacol Ther 2012; 3: 29–33.

    Article  Google Scholar 

  2. Enattah NS, Sahi T, Savilahti E, Terwillinger JD, Peltonen L, Järvelä I . Identification of a variant associated with adult-type hypolactasia. Nat Genet 2002; 30: 233–237.

    Article  CAS  Google Scholar 

  3. Enko D, Rezanka E, Stolba R, Halwachs-Baumann G . Lactose malabsorption testing in daily clinical practice: a critical retrospective analysis and comparison of the hydrogen/methane breath test and genetic test (c/t-13910 polymorphism) results. Gastroenterol Res Pract 2014; 2014: 464382.

    Article  Google Scholar 

  4. Gugatschka M, Dobnig H, Fahrleitner-Pammer A, Pietschmann P, Kudlacek S, Strele A et al. Molecularly-defined lactose malabsorption, milk consumption and anthropometric differences in adult males. QJM 2005; 98: 857–863.

    Article  CAS  Google Scholar 

  5. Eisenmann A, Amann A, Said M, Datta B, Ledochowski M . Implementation and interpretation of hydrogen breath tests. J Breath Res 2008; 2: 046002.

    Article  Google Scholar 

  6. Enko D, Kriegshäuser G, Kimbacher C, Stolba R, Mangge H, Halwachs-Baumann G . Carbohydrate malabsorption and putative carbohydrate-specific small intestinal bacterial overgrowth: prevalence and diagnostic overlap observed in an Austrian outpatient center. Digestion 2015; 92: 32–38.

    Article  CAS  Google Scholar 

  7. Enattah N, Välimäki VV, Välimäki MJ, Löyttyniemi E, Sahi T, Järvelä I . Molecularly defined lactose malabsorption, peak bone mass and bone turnover rate in young Finnish men. Calcif Tissue Int 2004; 75: 488–493.

    Article  CAS  Google Scholar 

  8. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1911–1930.

    Article  CAS  Google Scholar 

  9. Enko D, Kriegshäuser G, Stolba R, Worf E, Halwachs-Baumann G . Method evaluation study of a new generation of vitamin D assays. Biochem Med 2015; 25: 203–212.

    Article  Google Scholar 

  10. Obermayer-Pietsch BM, Bonelli CM, Walter DE, Kuhn RJ, Fahrleitner-Pammer A, Berghold A et al. Genetic predisposition for adult lactose intolerance and relation to diet, bone density, and bone fractures. J Bone Miner Res 2004; 19: 42–47.

    Article  Google Scholar 

  11. Högenauer C, Hammer HF, Mellitzer K, Renner W, Krejs GJ, Toplak H . Evaluation of a new DNA test compared with the lactose hydrogen breath test for the diagnosis of lactase non-persistence. Eur J Gastroenterol Hepatol 2005; 17: 371–376.

    Article  Google Scholar 

  12. Kudlacek S, Schneider B, Peterlik M, Leb G, Klaushofer K, Weber K et al. Assessment of vitamin D and calcium status in healthy adult Austrians. Eur J Clin Invest 2003; 33: 323–331.

    Article  CAS  Google Scholar 

  13. Nieves JW . Osteoporosis: the role of micronutrients. Am J Clin Nutr 2005; 81: 1232S–1239S.

    Article  CAS  Google Scholar 

  14. Enattah NS, Sulkava R, Halonen P, Kontula K, Järvelä I . Genetic variant of lactase-persistent C/T-13910 is associated with bone fractures in very old age. J Am Geriatr Soc 2005; 53: 79–82.

    Article  Google Scholar 

  15. Bácsi K, Kósa JP, Lazáry A, Balla B, Horváth H, Kis A et al. LCT 13910 C/T polymorphism, serum calcium, and bone mineral density in postmenopausal women. Osteoporos Int 2009; 20: 639–645.

    Article  Google Scholar 

  16. Brown JP, Albert C, Nassar BA, Adachi JD, Cole D, Davison KS et al. Bone turnover markers in the management of postmenopausal osteoporosis. Clin Biochem 2009; 42: 929–942.

    Article  CAS  Google Scholar 

  17. Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporosis Int 2011; 22: 391–420.

    Article  CAS  Google Scholar 

  18. Eastell R, Garnero P, Audebert C, Cahall DL . Reference intervals of bone turnover markers in healthy premenopausal women: results from a cross-sectional European study. Bone 2012; 50: 1141–1147.

    Article  Google Scholar 

  19. Lee J, Vasikaran S . Current recommendations for laboratory testing and use of bone turnover markers in management of osteoporosis. Ann Lab Med 2012; 32: 105–112.

    Article  CAS  Google Scholar 

  20. Gossiel F, Finigan J, Jacques R, Reid D, Felsenberg D, Roux C et al. Establishing reference intervals for bone turnover markers in healthy postmenopausal women in a nonfasting state. Bonekey Rep 2014; 3: 573.

    Article  CAS  Google Scholar 

  21. Chapurlat RD, Garnero P, Bréart G, Meunier PJ, Delmas PD . Serum type I collagen breakdown product (serum CTX) predicts hip fracture risk in elderly women: the EPIDOS study. Bone 2000; 27: 283–286.

    Article  CAS  Google Scholar 

  22. Glover SJ, Garnero P, Naylor K, Rogers A, Eastell R . Establishing a reference range for bone turnover markers in young, healthy women. Bone 2008; 42: 623–630.

    Article  CAS  Google Scholar 

  23. Johansson H, Odén A, Kanis JA, McCloskey EV, Morris HA, Cooper C et al. A meta-analysis of reference markers of bone turnover for prediction of fracture. Calcif Tissue Int 2014; 94: 560–567.

    Article  CAS  Google Scholar 

  24. Glover SJ, Gall M, Schoenborn-Kellenberger O, Wagener M, Garnero P, Boonen S et al. Establishing a reference interval for bone turnover markers in 637 healthy, young, premenopausal women from the United Kingdom, France, Belgium, and the United States. J Bone Miner Res 2009; 24: 389–397.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D Enko.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Enko, D., Kriegshäuser, G., Stolba, R. et al. Assessment of vitamin D status and serum CrossLaps levels in adults with primary lactose malabsorption. Eur J Clin Nutr 70, 1000–1003 (2016). https://doi.org/10.1038/ejcn.2016.66

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2016.66

Search

Quick links