Adult lactose intolerance, calcium intake, bone metabolism and bone density in German-Turkish immigrants



Adult lactose intolerance (ALI) significantly alters calcium intake and absorption, and thus may promote osteoporosis. ALI is a recessive condition with a geographical north–south gradient characterised by decreased levels of intestinal lactase. PCR-based genotyping of lactase (LCT) gene polymorphisms is a safe and easy way to diagnose ALI and may complement diagnostic procedures to identify individuals at risk for reduced calcium intake and subsequently osteoporosis due to lactose malabsorption. Therefore, we investigated the frequency of ALI and its influence on calcium intake, markers of bone metabolism and bone mineral density (BMD) in a cohort of Turkish immigrants living in Germany.

Materials and methods

We investigated single nucleotide polymorphisms of the LCT gene, calcium intake, markers of bone metabolism and BMD in 183 Turkish immigrants.


ALI was diagnosed in 154 out of 183 (81%) probands. ALI was significantly associated with self-reported lactose intolerance (p < 0.001) and dislike for dairy products (p < 0.01). Osteopenia was diagnosed in 59 out of 183 (32%) and osteoporosis in 15 out of 183 (8%) probands. Probands with reduced BMD had ALI in 86%. All probands had a decreased calcium intake [mg/week]. There was no significant association between ALI, calcium intake, markers of bone metabolism or BMD.


Turkish immigrants mostly have ALI and overall show a reduced calcium intake per week. However, ALI did not significantly influence calcium intake, markers of bone metabolism or BMD in this cohort. Therefore, ALI in Turkish immigrants does not seem to be a risk factor for osteoporosis.

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The authors are grateful to the sub-investigators, patients and hospital staff who participated in this study. We acknowledge the statistical support of MoReData GmbH, Kerkrader Strasse 11, 35394, Giessen, Germany.


There was no financial support.

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PK analysed the data and prepared the manuscript. GD collected the data. UL collected and analysed the data and prepared the manuscript. All the authors participated in the preparation and drafting of the manuscript and approved its final version for publication.

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Correspondence to Philipp Klemm.

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All the authors approved the entirety of the submitted material and contributed actively to the study.

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Klemm, P., Dischereit, G. & Lange, U. Adult lactose intolerance, calcium intake, bone metabolism and bone density in German-Turkish immigrants. J Bone Miner Metab 38, 378–384 (2020).

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  • Turkish immigrants
  • Lactase polymorphism
  • Calcium intake
  • Bone mineral density