Duodenal Disaccharidase Activities During and After Weaning off Parenteral Nutrition in Pediatric Intestinal Failure.
J Pediatr Gastroenterol Nutr
; 64(5): 777-782, 2017 05.
Article
in En
| MEDLINE
| ID: mdl-27482764
ABSTRACT
OBJECTIVES:
Data on factors affecting absorptive function in children with intestinal failure (IF) are sparse. We evaluated duodenal disaccharidase activities and inflammation in relation to parenteral nutrition (PN) and intestinal resection in pediatric onset IF.METHODS:
Disaccharidase (maltase, sucrase, and lactase) activities and histologic inflammation were evaluated from duodenal biopsies in 58 patients during PN (nâ=â23) or full enteral nutrition (nâ=â40) and in 43 matched controls. The first and the last postresection biopsies were analyzed separately after 4.3 (1.2-9.7) years and 6.5 (2.3-12.4) years, respectively.RESULTS:
During PN, maltase and sucrase activities were 1.6-fold lower and mucosal inflammation more frequent (22% vs 3%) when compared to matched controls (Pâ<â0.05 for both). In patients on full enteral nutrition, activities of maltase and sucrase were significantly higher than that in patients receiving PN and comparable to those of matched controls. Postresection time correlated positively (râ=â0.448 and râ=â0.369) and percentage length of the remaining small intestine inversely (râ=â-0.337 and râ=â-0.407) with maltase and sucrase activity in patients on full enteral nutrition (Pâ<â0.05 for all), whereas proportional length of remaining colon correlated positively with maltase and lactase activity (râ=â0.424-0.544, Pâ<â0.05) in patients receiving PN.CONCLUSIONS:
In children with IF, PN dependency associated with decreased duodenal maltase and sucrase activities and mucosal inflammation, which may disturb intestinal absorptive function. Localization and extent of intestinal resection and post-resection time correlated with duodenal disaccharidase activities.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Parenteral Nutrition, Total
/
Disaccharidases
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Duodenum
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Intestinal Absorption
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Intestinal Diseases
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Intestinal Mucosa
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Child
/
Child, preschool
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Female
/
Humans
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Infant
/
Male
Language:
En
Journal:
J Pediatr Gastroenterol Nutr
Year:
2017
Type:
Article
Affiliation country:
Finland