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Adult-type hypolactasia and calcium availability: decreased calcium intake or impaired calcium absorption?

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Abstract

Summary

Adult-type hypolactasia, as mediated by a widespread genetic predisposition, not only reduces calcium intake but also calcium absorption in the presence of high amounts of lactose and may, therefore, promote osteoporosis. A lactose-reduced diet and lactose-free calcium supplements may reverse this imbalance.

Introduction and hypothesis

Adult-type hypolactasia (HL) defined by the LCT(−13910) polymorphism may reduce calcium intake by reducing dairy consumption and, therefore, promote osteoporosis. This study aimed to evaluate whether lactose also decreases intestinal calcium absorption in subjects with HL and whether lactose-reduced diet and lactose-free calcium supplementation as recommended could maintain bone mineral density (BMD).

Methods

Based on LCT genotyping, 73 postmenopausal women with and without HL underwent a conventional H2 breath test with a concomitant oral strontium absorption test lasting 150 minutes, which closely reflects intestinal calcium absorption. In addition, we compared bone-specific laboratory parameters, lumbar and femoral BMD, and spinal radiographs to a similar bone assessment 5 years earlier.

Results

LCT genotyping and functional lactose malabsorption tests were highly correlated. Dairy product consumption was reduced by 80% in HL individuals. During concomitant lactose application, mean strontium absorption was blunted by 54% in HL subjects after 150 minutes (1272 ± 629 μg/L vs. 2020 ± 1130 μg/L in lactose tolerant subjects, p = 0.001). Nevertheless, BMD in HL subjects remained stable with lactose-free calcium supplements during the observation period.

Conclusion

Both decreased calcium intake as well as lactose-associated impaired calcium absorption may predispose subjects with HL to osteoporosis. Lactose-free calcium supplementation may help to maintain BMD in HL subjects.

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Authors and Affiliations

  1. Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036, Graz, Austria

    B. M. Obermayer-Pietsch, M. Gugatschka, S. Reitter, W. Plank, D. Walter, C. Bonelli, H. Dobnig & A. Fahrleitner-Pammer

  2. Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria

    C. Högenauer

  3. Center for Medical Research, Unit of Biostatistics, Medical University of Graz, Graz, Austria

    A. Strele

  4. Institute of Chemistry-Analytical Chemistry, Karl-Franzens University, Graz, Austria

    W. Goessler

  5. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria

    W. Renner

Authors
  1. B. M. Obermayer-Pietsch
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  2. M. Gugatschka
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  3. S. Reitter
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  4. W. Plank
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  5. A. Strele
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  6. D. Walter
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  7. C. Bonelli
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  9. H. Dobnig
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  10. C. Högenauer
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  11. W. Renner
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  12. A. Fahrleitner-Pammer
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Correspondence to B. M. Obermayer-Pietsch.

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Obermayer-Pietsch, B.M., Gugatschka, M., Reitter, S. et al. Adult-type hypolactasia and calcium availability: decreased calcium intake or impaired calcium absorption?. Osteoporos Int 18, 445–451 (2007). https://doi.org/10.1007/s00198-006-0251-6

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  • DOI: https://doi.org/10.1007/s00198-006-0251-6

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