Lactose Intolerance in Indonesian Children

印尼兒童的乳糖不耐症

Badriul Hegar ； Ariani Widodo

《Asia Pacific Journal of Clinical Nutrition》 24卷S1期 (2015/12) Pp. s31-s40

https://doi.org/10.6133/apjcn.2015.24.s1.06

摘要

在亞洲及世界的許多地區，“乳糖不耐症（LI）”被認為是一個常見的問題。它的盛行率及好發年齡依亞洲國家而有所差異，這可能與基因或是文化因素有關。過去二十年來，印尼有3-15歲兒童採用純的乳糖耐受性試驗的研究，可作為探討此議題之用。乳糖吸收不良（LM）的盛行率在學齡前（3-5歲）、國小（6-11歲）及初中（12-14歲）學童分別為21.3%、57.8%及73%。LM盛行率在學齡前兒童有增加的趨勢，從3歲的9.1%至5歲的28.6%。初中生組（JHS）LI最常見的症狀為腹痛（64.1%）、腹部脹氣（22.6%）、噁心（15.1%）、腸胃脹氣／排氣（5.7%）及腹瀉（1.9%），大部分是在攝取乳糖一個小時內出現。規律與不規律飲用牛奶的兒童，LM發生分別為81.2%及69.2%；LI則為56.2%及52.1%。大部分初中生如有乳製品相關再復發腹痛（RAP）症狀者，即認為是吸收不良者。與RAP最相關的乳製品是牛奶及優格。81%的RAP兒童被發現有LI，其中以腹痛最常發生，再來是噁心、腹脹、腹瀉、腹鳴及腸胃脹氣／排氣。通常在攝取乳糖30分鐘後，開始有症狀，特別是噁心、腹脹及腹痛。在RAP學童，LI症狀最常發生在BHC大於20 ppm。很多LI症狀可在吸收不良者發現，但症狀輕微且通常於7小時內消失，至多為15小時。

關鍵字

乳糖不耐症 ； 乳糖吸收不良 ； 兒童 ； 乳糖酶缺乏 ； 印尼

並列摘要

＂Lactose intolerance (LI)＂ is considered a common problem in Asians, and in many parts of the world. Its prevalence and age of manifestation varies between by Asian country, for possible genetic or cultural reasons. Studies in Indonesian children 3-15 years old (y) are available within the past two decades, using a pure lactose tolerance test. The prevalences of lactose malabsorption (LM) in pre-elementary (3-5 y), elementary (6-11 y), and junior high (12-14 y) school-children were 21.3%, 57.8%, and 73%, respectively. An increasing trend for LM prevalence was seen within the pre-elementary group, from 9.1% at 3 y to 28.6% at 5 y. The most frequent symptoms of LI in junior high school (JHS) group were abdominal pain (64.1%), abdominal distention (22.6%), nausea (15.1%), flatulence (5.7%), and diarrhea (1.9%), mostly within one hour of lactose ingestion. In children with regular and irregular milk drinking, LM occurred in 81.2% and 69.6%; LI was found in 56.2% and 52.1%, respectively. Most JHS children with dairy-associated recurrent abdominal pain (RAP) symptoms proved to be malabsorbers. Dairy products most related to RAP were milk and yogurt. LI was found in 81% of RAP children with abdominal pain most frequently, followed by nausea, bloating, diarrhea, borborygmi, and flatulence. Symptom onset occurred 30 minutes after lactose ingestion, especially nausea, bloating, and abdominal pain. In RAP children LI symptoms mostly found in breath hydrogen concentration ＞20 ppm. More LI symptoms were found in lactose malabsorbers, but symptoms were mild and generally disappeared in 7 hours, and in most by 15 hours.

並列關鍵字

lactose intolerance ； lactose malabsorption ； children ； lactase deficiency ； Indonesia