Top

Journal of Bone and Mineral Metabolism

Published in:

01-05-2020 | Lactose Intolerance | Original Article

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

Authors: Philipp Klemm, Gabriel Dischereit, Uwe Lange

Published in: Journal of Bone and Mineral Metabolism | Issue 3/2020

Abstract

Introduction

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.

Results

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.

Conclusion

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.

Sahi T, Isokoski M, Jussila J, Launiala K, Pyörälä K (1973) Recessive inheritance of adult-type lactose malabsorption. Lancet 302:823–826. https://doi.org/10.1016/S0140-6736(73)90862-3 CrossRef

Tamm A (1994) Management of lactose intolerance. Scand J Gastroenterol Suppl 202:55–63CrossRef

Obermayer-Pietsch BM, Gugatschka M, Reitter S, Plank W, Strele A, Walter D, Bonelli C, Goessler W, Dobnig H Högenauer C, Renner W, Fahrleitner-Pammer A (2007) Adult-type hypolactasia and calcium availability: Decreased calcium intake or impaired calcium absorption? Osteoporos Int 18:445–451. https://doi.org/10.1007/s00198-006-0251-6 CrossRefPubMed

Obermayer-Pietsch BM, Bonelli CM, Walter DE, Kuhn RJ, Fahrleitner-Pammer A, Berghold A, Goessler W, Stepan V, Dobnig H, Leb G, Renner W (2004) Genetic predisposition for adult lactose intolerance and relation to diet, bone density, and bone fractures. J Bone Miner Res 19:42–47. https://doi.org/10.1359/JBMR.0301207 CrossRefPubMed

Finkenstedt G, Skrabal F, Gasser RW, Braunsteiner H (1986) Lactose absorption, milk consumption, and fasting blood glucose concentrations in women with idiopathic osteoporosis. Br Med J (Clin Res Ed) 292:161–162. https://doi.org/10.1136/bmj.292.6514.161 CrossRef

Enattah N, Pekkarinen T, Välimäki MJ, Löyttyniemi E, Järvelä I (2005) Genetically defined adult-type hypolactasia and self-reported lactose intolerance as risk factors of osteoporosis in Finnish postmenopausal women. Eur J Clin Nutr 59:1105–1111. https://doi.org/10.1038/sj.ejcn.1602219 CrossRefPubMed

Corazza GR, Benati G, Sario A, Tarozzi C, Strocchi A, Passeri M, Gasbarrini G (1995) Lactose intolerance and bone mass in postmenopausal Italian women. Br J Nutr 73:479–487. https://doi.org/10.1079/bjn19950050 CrossRefPubMed

Hammer HF, Petritsch W, Pristautz H, Krejs GJ (1996) Assessment of the influence of hydrogen nonexcretion on the usefulness of the hydrogen breath test and lactose tolerance test. Wien Klin Wochenschr 108:137–141PubMed

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

10.

Kerber M, Oberkanins C, Kriegshäuser G, Kollerits B, Dossenbach-Glaninger A, Fuchs D, Ledochowski M (2007) Hydrogen breath testing versus LCT genotyping for the diagnosis of lactose intolerance: a matter of age? Clin Chim Acta 383:91–96. https://doi.org/10.1016/j.cca.2007.04.028 CrossRefPubMed

11.

Enattah NS, Sahi T, Savilahti E, Terwilliger JD, Peltonen L, Järvelä I (2002) Identification of a variant associated with adult-type hypolactasia. Nat Genet 30:233–237. https://doi.org/10.1038/ng826 CrossRefPubMed

12.

Kuokkanen M, Enattah NS, Oksanen A, Savilahti E, Orpana A, Järvelä I (2003) Transcriptional regulation of the lactase-phlorizin hydrolase gene by polymorphisms associated with adult-type hypolactasia. Gut 52:647–652. https://doi.org/10.1136/gut.52.5.647 CrossRefPubMedPubMedCentral

13.

Tastan Y, Kann PH, Tinneberg HR, Hadji P, Müller-Ladner U, Lange U (2016) Low bone mineral density and vitamin d deficiency correlated with genetics and other bone markers in female Turkish immigrants in Germany. Clin Rheumatol 35:2789–2795. https://doi.org/10.1007/s10067-016-3237-6 CrossRefPubMed

14.

Erkal MZ, Wilde J, Bilgin Y, Akinci A, Demir E, Bödeker RH, Mann M, Bretzel R, Stracke H, Holick MF (2006) High prevalence of vitamin D deficiency, secondary hyperparathyroidism and generalized bone pain in Turkish immigrants in Germany: identification of risk factors. Osteoporos Int 17:1133–1140. https://doi.org/10.1007/s00198-006-0069-2 CrossRefPubMed

15.

Tarner IH, Erkal MZ, Obermayer-Pietsch BM, Hofbauer LC, Bergmann S, Goettsch C, Madlener K, Müller-Ladner U, Lange U (2012) Osteometabolic and osteogenetic pattern of Turkish immigrants in Germany. Exp Clin Endocrinol Diabetes 120:517–523. https://doi.org/10.1055/s-0032-1321808 CrossRefPubMed

16.

Ross AC, Taylor CL, Yaktine AL, Valle HB Del (2011) Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press, Washington, DC

17.

Black RE, Williams SM, Jones LE, Goulding A (2002) Children who avoid drinking cow milk have low dietary calcium intakes and poor bone health. Am J Clin Nutr 76:675–680. https://doi.org/10.1093/ajcn/76.3.675 CrossRefPubMed

18.

Gugatschka M, Dobnig H, Fahrleitner-Pammer A, Pietschmann P, Kudlacek S, Strele A, Obermayer-Pietsch BM (2005) Molecularly-defined lactose malabsorption, milk consumption and anthropometric differences in adult males. QJM - Mon J Assoc Physicians 98:857–863. https://doi.org/10.1093/qjmed/hci140

19.

Gugatschka M, Hoeller A, Fahrleitner-Pammer A, Dobnig H, Pietschmann P, Kudlacek S, Obermayer-Pietsch BM (2007) Calcium supply, bone mineral density and genetically defined lactose maldigestion in a cohort of elderly men. J Endocrinol Invest 30:46–51. https://doi.org/10.1007/BF03347395

20.

Ross AC, Taylor CL, Yaktine AL, Valle HB (2012) Dietary reference intakes for calcium and vitamin D. Pediatrics 130:e1424–e1424. https://doi.org/10.1542/peds.2012-2590 CrossRef

Title: Adult lactose intolerance, calcium intake, bone metabolism and bone density in German-Turkish immigrants
Authors: Philipp Klemm
Gabriel Dischereit
Uwe Lange
Publication date: 01-05-2020
Publisher: Springer Singapore
Keywords: Lactose Intolerance
Vitamin D Deficiency
Osteoporosis
Osteoporosis
Published in: Journal of Bone and Mineral Metabolism / Issue 3/2020
Print ISSN: 0914-8779
Electronic ISSN: 1435-5604
DOI: https://doi.org/10.1007/s00774-019-01070-4

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Introduction

Materials and methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2020

Bazedoxifene improves renal function and increases renal phosphate excretion in patients with postmenopausal osteoporosis

Time to benefit and the long-term persistence of new users of oral bisphosphonates

18F-NaF-PET/CT in patients with primary hyperparathyroidism and brown tumors

Coding and prescription rates of osteoporosis are low among distal radius fracture patients in Japan

Intra-articular injection of hUC-MSCs expressing miR-140-5p induces cartilage self-repairing in the rat osteoarthritis

Relationship between P1NP, a biochemical marker of bone turnover, and bone mineral density in patients transitioned from alendronate to romosozumab or teriparatide: a post hoc analysis of the STRUCTURE trial

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page