Summary
Controversy exists over the etiology of primary lactose intolerance with intestinal lactase deficiency. The low activity of lactase may be either due to a genetically controled reduction of enzyme activity or to an adaptive response to a lack of dietary lactose. Lactose tolerance tests in 24 subjects (9 persons who are offspring of marriages between Asians and Europeans, 6 lactose tolerant individuals from populations with a high incidence of lactose intolerance, and 9 lactose intolerant subjects with a history of prolonged milk consumption) are more easily interpreted by assuming genetic control of lactase activity as the main determinant of lactose tolerance. The findings in these 24 subjects contradict some of the commonly cited arguments supporting an adaptive origin of lactose intolerance.
Zusammenfassung
Die Ätiologie der primären Lactose-Intoleranz bei Lactase-Mangel in der Dünndarmschleimhaut ist ungeklärt. Die mangelnde Aktivität der intestinalen Lactase könnte durch eine genetisch gesteuerte Erniedrigung oder durch eine Anpassung an einen Mangel von Lactose in der Nahrung erklärt werden. Die Ergebnisse von Lactose-Toleranztests bei 24 Versuchspersonen (9 Kindern aus Ehen zwischen Asiaten und Europäern, 6 Personen mit Lactose-Toleranz aus Bevölkerungen mit einer großen Häufigkeit der Lactose-Intoleranz und 9 Probanden mit Lactose-Intoleranz, die lange Zeit größere Mengen von Kuhmilch genossen hatten) lassen sich leichter unter der Annahme einer genetischen Bedingtheit der Lactase-Aktivität als unter der Annahme der Adaptation interpretieren. Die Befunde bei diesen 24 Versuchspersonen widersprechen einigen der Argumente, die für eine adaptive Bedingtheit der Lactose-Intoleranz angeführt werden.
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References
Bayless, T. M., Rosensweig, N. S.: A racial difference in incidence of lactase deficiency. A survey of milk intolerance and lactase deficiency in healthy adult males. J. Amer. med. Ass. 197, 968 (1966).
Bolin, T. D.: Reply to Gilat (1971). Gastroenterology 60, 347 (1971).
— Davis, A. E.: Asian lactose intolerance and its relation to intake of lactose. Nature (Lond.) 222, 382 (1969).
—: Lactose intolerance in Australia-born Chinese. Austr. Ann. Med. 19, 40 (1970a)
—: Primary lactase deficiency: genetic or acquired? Amer. J. dig. Dis. 15, 679 (1970b).
— Seah, C. S., Chua, K. L., Yong, V., Kho, K. M., Siak, C. L., Jacob, E.: Lactose intolerance in Singapore. Gastroenterology 59, 76 (1970c).
— McKern, A., Davis, A. E.: The effect of diet on lactose activity in the rat. Gastroenterology 60, 432 (1971).
— Pirola, R. C., Davis, A. E.: Adaptation of intestinal lactase in the rat. Gastroenterology 57, 406 (1969).
Cain, G. D., Moore, P., Patterson, M., McElveen, M. A.: The stimulation of lactase by feeding lactose. Scand. J Gastroenterol. 4, 545 (1969).
Cook, G. C., Kajubi, S. K.: Tribal incidence of lactase deficiency in Uganda. Lancet 1966 I, 725.
Cuatrecasas, P., Lockwood, D. H., Caldwell, J.: Lactase deficiency in the adult, a common occurrence. Lancet 1965 I, 14.
Fine, A., Willoughby, E., McDonald, G. S. A., Weir, D. G., Gatenby, P. B.: A family with intolerance to lactose and cold milk. Irish. J. med. Sci. 1, 321 (1968).
Flatz, G., Saengudom, Ch.: Lactose tolerance in Asians: a family study. Nature (Lond.) 224, 915 (1969).
Gilat, T.: Lactase — an adaptable enzyme? Gastroenterology 60, 346 (1971).
Girardet, P., Richterich, R., Antener, I.: Adaption de la lactase intestinale a l'administration de lactose chez le rat adulte. Helv. physiol pharmacol. Acta 22, 7 (1964).
Gray, G. M., Walter, W. M., Colver, E. H.: Persistent deficiency of intestinal lactase in apparently cured tropical sprue. Gastroenterology 55, 552 (1968).
Grütte, F. K., Schulze, J., Gärtner, H.: Alimentär bedingte Adaptation der mukosalen β-Galactosidase-Aktivität bei der Ratte. VIII. Intern. Congr. Nutrition, Abstr. G—31. Prag 1969.
Gudmand-Höyer, E., Jarnum, S.: Lactose malabsorption in Greenland Eskimos. Acta med. scand. 186, 235 (1969).
— Dahlqvist, A., Jarnum, S.: Specific small-intestinal lactase deficiency in adults. Scand. J. Gastroent. 4, 377 (1969).
Keusch, G. T., Troncale, F. J., Miller, L. H., Promdath, V., Anderson, P. R.: Acquired lactose malabsorption in Thai children. Pediatrics 43, 540 (1969).
McCracken, R. D.: Adult lactose tolerance (editorial). J. Amer. med. Ass. 213, 2257 (1970).
Rosensweig, N. S.: Adult lactase deficiency: genetic control or adaptive response? Gastroenterology 60, 464 (1971).
Shatin, R.: Evolution and lactase deficiency. Gastroenterology 54, 992 (1968).
Simoons, F. J.: Primary adult lactose intolerance and the milking habit: a problem of biological and cultural interrelations. I. Review of the medical research. Amer. J. dig. Dis. 14, 819 (1969).
Welsh, J. D.: Isolated lactase deficiency in humans: report on 100 patients. Medicine (Baltimore) 49, 257 (1970).
— Zschiesche, O. M., Willits, V. L., Russel, L.: Studies of lactose intolerance in families. Arch. intern. Med. 122, 315 (1968).
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Supported by Stiftung Volkswagenwerk.
Supported by Landesamt für Forschung, Nordrhein-Westfalen.
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Flatz, G., Rotthauwe, H.W. Evidence against nutritional adaption of tolerance to lactose. Humangenetik 13, 118–125 (1971). https://doi.org/10.1007/BF00295793
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DOI: https://doi.org/10.1007/BF00295793