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Changes in small-intestine permeability with aging

J R Saltzman1, K V Kowdley, G Perrone

  • 1USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.

Journal of the American Geriatrics Society
|February 1, 1995
PubMed
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Aging does not increase small intestine "leakiness." While the excretion of lactulose and mannitol decreases with age, the lactulose/mannitol ratio remains stable, indicating no change in intestinal permeability.

Area of Science:

  • Gastroenterology
  • Aging Research
  • Human Physiology

Background:

  • Small intestine mucosal integrity and permeability are crucial for nutrient absorption and barrier function.
  • Age-related changes in gastrointestinal function are not fully understood, particularly concerning intestinal permeability.

Purpose of the Study:

  • To assess changes in small intestine mucosal integrity and permeability in healthy individuals across different age groups.
  • To evaluate the utility of the lactulose/mannitol absorption test in measuring age-related alterations in intestinal function.

Main Methods:

  • A prospective cohort study involving 56 healthy subjects across three age groups (20-39, 40-59, ≥60 years).
  • Subjects ingested lactulose and mannitol after an overnight fast, with urine collected for 6 hours to measure excretion.

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  • High-performance liquid chromatography analyzed lactulose and mannitol levels; 24-hour creatinine clearance was also determined.

    • Main Results:

    • A progressive decline in the percentage of both lactulose and mannitol excreted was observed with increasing age (P = 0.09 and P = 0.05, respectively).
    • The lactulose/mannitol ratio showed no significant change with age (P = 0.65) due to parallel decreases in both sugar excretions.
    • Creatinine clearance significantly decreased with age (P < .001) and correlated with the reduced excretion of lactulose and mannitol (P < .02).

    Conclusions:

    • The ability to excrete lactulose and mannitol declines with advancing age, likely due to diminished renal function.
    • Despite reduced excretion, the lactulose/mannitol ratio remains constant, suggesting that small intestine permeability does not increase with aging.
    • The lactulose/mannitol absorption test is a reliable indicator for assessing intestinal permeability, showing no age-related increase in "leakiness."