{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:27:25Z","timestamp":1791012445582,"version":"4.1.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2008,1,1]],"date-time":"2008-01-01T00:00:00Z","timestamp":1199145600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2008,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Currently, there is no \u2018gold standard\u2019 for detecting patients with sensitivity to lactose. Biochemical investigation by a breath hydrogen test alone detects &lt;50% cases. Breath methane and symptoms are not recorded as standard practice. The clinical value of analysing C\/T\n                      <jats:sub>13910<\/jats:sub>\n                      and G\/A\n                      <jats:sub>22018<\/jats:sub>\n                      polymorphisms, strongly associated with lactose sensitivity, has not been established.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Two hundred and ten patients with unexplained gut and systemic symptoms and controls were challenged with 50 g lactose. Breath hydrogen and methane were measured and symptoms recorded. All were genotyped for two polymorphisms, C\/T\n                      <jats:sub>13910<\/jats:sub>\n                      and G\/A\n                      <jats:sub>22018<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CC\n                      <jats:sub>13910<\/jats:sub>\n                      \/GG\n                      <jats:sub>22018<\/jats:sub>\n                      in 14.5%, CT\n                      <jats:sub>13910<\/jats:sub>\n                      \/GA\n                      <jats:sub>22018<\/jats:sub>\n                      in 39% and TT\n                      <jats:sub>13910<\/jats:sub>\n                      \/AA\n                      <jats:sub>22018<\/jats:sub>\n                      in 46.5%. One hundred percent of CC\n                      <jats:sub>13910<\/jats:sub>\n                      \/GG\n                      <jats:sub>22018<\/jats:sub>\n                      were lactose sensitive having a breath hydrogen &gt;20 ppm within 6 h and symptoms. But the breath hydrogen test lacked sensitivity and specificity in the other groups. There was elevated breath hydrogen in 21% of CT\n                      <jats:sub>13910<\/jats:sub>\n                      \/GA\n                      <jats:sub>22018<\/jats:sub>\n                      and 15% of TT\n                      <jats:sub>13910<\/jats:sub>\n                      \/AA\n                      <jats:sub>22018<\/jats:sub>\n                      by 6 h, whereas 17 and 30.9% had elevated breath methane alone. Breath methane and breath hydrogen with clinical symptoms improved sensitivity and specificity, increasing detection of lactose sensitivity in genotypes CT\/GA and TT\/AA from &lt;50 to &gt;75%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The data presented define the current best practice for the clinical identification of lactose sensitivity. Patients were first genotyped. Those identified as CC with symptoms should immediately undertake a 12-week lactose-free diet. Those identified as CT or TT should undertake a breath hydrogen and methane test. Those positive for hydrogen or methane along with symptoms or with symptoms only, should also undertake a lactose-free diet. Those with high hydrogen without symptoms should be investigated for causes other than lactose sensitivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1258\/acb.2007.007147","type":"journal-article","created":{"date-parts":[[2008,2,9]],"date-time":"2008-02-09T15:22:53Z","timestamp":1202570573000},"page":"50-58","source":"Crossref","is-referenced-by-count":43,"title":["Measurement of breath hydrogen and methane, together with lactase genotype, defines the current best practice for investigation of lactose sensitivity"],"prefix":"10.1177","volume":"45","author":[{"given":"Jonathan P","family":"Waud","sequence":"first","affiliation":[{"name":"Department of Medical Biochemistry and Immunology, Llandough Hospital, Cardiff and Vale NHS Trust, Llandough, Vale of Glamorgan, South Wales, Cardiff CF64 2XX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie B","family":"Matthews","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Immunology, Llandough Hospital, Cardiff and Vale NHS Trust, Llandough, Vale of Glamorgan, South Wales, Cardiff CF64 2XX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony K","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Immunology, Cardiff University, Tenovus Building, Heath Park Campus, Heath Park, Cardiff CF14 4XN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2008,1,1]]},"reference":[{"key":"bibr-ACB-07-147C1","doi-asserted-by":"publisher","DOI":"10.1038\/ng826"},{"key":"bibr-ACB-07-147C2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.52.5.647"},{"key":"bibr-ACB-07-147C3","doi-asserted-by":"publisher","DOI":"10.1007\/BF00284435"},{"key":"bibr-ACB-07-147C4","volume-title":"Milk is Not for Everybody","author":"Carper S","year":"1995"},{"key":"bibr-ACB-07-147C5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02116-4"},{"key":"bibr-ACB-07-147C6","first-page":"56","volume":"20","author":"Matthews SB","year":"2004","journal-title":"Welsh Paediatric J"},{"key":"bibr-ACB-07-147C7","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2004.025551"},{"key":"bibr-ACB-07-147C8","doi-asserted-by":"publisher","DOI":"10.1016\/j.lab.2004.10.005"},{"key":"bibr-ACB-07-147C9","unstructured":"Fauchi AS, Braunwald E, Isselbacher KJ, eds. 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