Intestinal malabsorption of D-xylose: comparison of test modalities in patients with celiac disease.

Abstract

OBJECTIVE:

The aim of the study was to compare three different D-xylose test modalities for small intestinal malabsorption, using patients with celiac disease and healthy persons as experimental models.

MATERIAL AND METHODS:

Ninety-one untreated celiac patients, 98 treated celiac patients, and 43 healthy subjects performed the (13)C-D-xylose breath test. 1-h plasma D-xylose levels were measured in 48 untreated patients, 41 treated patients and 41 healthy controls. 4-h urine D-xylose excretion was measured in 47 untreated patients, 51 treated patients and 42 healthy controls. 100 mg of (13)C-D-xylose and 5 g of D-xylose were dissolved in 250 ml tap water and given orally. (13)CO(2) was measured in breath every 30 min for 4 h. Blood was sampled after 1 h, and urine collected after 4 h.

RESULTS:

Test sensitivity/specificity for celiac disease was 88%/84% with the (13)C-D-xylose breath test, 65%/71% with the 1-h plasma D-xylose test, and 55%/74% with the 4-h urine D-xylose excretion test. Breath test results improved significantly in the treated celiac group compared to untreated patients, but were not normalized compared to healthy controls. No difference was found between 1-h plasma D-xylose levels and 4-h urinary D-xylose excretion in treated celiac patients and healthy controls.

CONCLUSIONS:

The (13)C-D-xylose breath test was superior to D-xylose testing in plasma and urine for assessment of small intestinal malabsorption with considerably higher sensitivity and specificity for untreated celiac disease.

• Authors: Kari Tveito, Cathrine Brunborg, Jorunn Bratlie, Mia Askedal, Leiv Sandvik, Knut E A Lundin, Viggo Skar
• Journal: Scandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 45 Issue 11 Pg. 1289-94 (Nov 2010) ISSN: 1502-7708 [Electronic] England
• PMID: 20626306 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Carbon Isotopes
• Carbon Dioxide
• Xylose

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Breath Tests (methods)
• Carbon Dioxide (analysis)
• Carbon Isotopes
• Celiac Disease (diagnosis, metabolism)
• Chromatography, High Pressure Liquid
• Diagnosis, Differential
• Female
• Follow-Up Studies
• Humans
• Intestinal Absorption (physiology)
• Intestine, Small (metabolism)
• Male
• Middle Aged
• ROC Curve
• Retrospective Studies
• Xylose (metabolism)
• Young Adult