Related Experiment Videos
Dual sugar permeability testing in diarrheal disease
A M Haase1, R H Kukuruzovic, K Dunn
1NT Clinical School (Flinders University), Royal Darwin Hospital, Casuarina, Northern Territory, Australia.
Insights
Blood tests are a valid alternative for intestinal permeability testing in children, significantly reducing the failure rate compared to urine collection. This method offers a more reliable assessment for young patients with diarrhea.
Area of Science:
- Pediatric Gastroenterology
- Biomedical Diagnostics
Background:
- 5-hour urine collection for sugar permeability tests has a high failure rate in young children.
- Acute gastroenteritis can impact intestinal permeability measurements.
Purpose of the Study:
- To evaluate the validity of using blood specimens for sugar permeability testing.
- To determine if blood tests reduce the failure rate compared to urine tests in children.
Main Methods:
- Simultaneous 5-hour urine and blood collections were performed after ingestion of lactulose and L-rhamnose.
- Sugar levels were measured using high-performance liquid chromatography, and results were expressed as an L-R ratio.
- Intestinal permeability was assessed in 24 children with acute gastroenteritis and 25 controls.
Main Results:
- The lactulose-rhamnose (L-R) ratio in blood for children with gastroenteritis was 9.4 (6.7 to 13.1), compared to 5.9 (4.4 to 7.8) in controls.
- The agreement between blood and urine L-R ratios was substantial (kappa = 0.71).
- The failure rate of the permeability test was significantly lower using blood (10%) versus urine (37%).
Conclusions:
- Intestinal permeability testing using blood specimens is a valid diagnostic alternative in pediatric patients.
- Blood-based testing significantly lowers the failure rate compared to traditional urine collection methods.
- This approach improves the reliability of permeability assessments in young children, particularly those with diarrhea.
Objective:
To assess the validity of the use of a blood specimen for the sugar permeability test because of the high failure rate of 5-hour urine collection in young children with diarrhea.
Study Design:
Simultaneous 5-hour urine collections and timed blood tests were taken after ingestion of an isotonic solution of lactulose (L) and L-rhamnose (R) in 24 children with acute gastroenteritis and 25 children without diarrhea in a control group. Sugars were measured with high performance liquid chromatography, and the percent of recovered sugars was expressed as an L-R ratio.
Results:
With acute gastroenteritis the geometric mean L-R ratios (95% confidence intervals) were 12.4 (9.3 to 16.3) in urine and 9.4 (6.7 to 13.1) in blood compared with 6.7 (5.0 to 8.8) and 5.9 (4.4 to 7.8), respectively, in the control group. The level of agreement (kappa) among normal, intermediate, and high ratios for blood and urine was 0.71 (0.51 to 0.92). The failure rate of L-R tests was significantly reduced with a blood specimen (urine 37% vs blood 10%; P <.0001).
Conclusions:
Intestinal permeability testing on a blood specimen is a valid alternative to urine collection in young children and has a significantly lower test failure rate.