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southern and northern Indian
Frequency of lactose malabsorption among healthy southern and
northern Indian populations by genetic analysis and lactose hydrogen
breath and tolerance tests1–3
Janaki Babu, Sunil Kumar, P Babu, Jaishri H Prasad, and Uday C Ghoshal
ABSTRACT
Background: Lactose malabsorption (LM), the inability to break
down lactose into glucose and galactose, is due to a deficiency in the
small intestinal lactase phlorizin hydrolase enzyme. Ethnic and geo-
graphic variations of LM are known.
Objective: The aim of this study was to compare the frequency of
LM in healthy southern and northern Indian populations.
Design: A total of 153 healthy volunteers (76 from southern and 77
from northern India) were evaluated for LM by using a lactose
tolerance test (LTT), a lactose hydrogen breath test (lactose
HBT), and polymerase chain reaction–restriction fragment length
polymorphism to identify the lactase gene C/T-13910 polymorphism
(confirmed by sequencing).
Results: Volunteers from southern and northern India were compa-
rable in age and sex. The LTT result was abnormal in 88.2% of
southern Indians and in 66.2% of northern Indians (P = 0.001). The
lactose HBT result was abnormal in 78.9% of southern Indians and
in 57.1% of northern Indians (P = 0.003). The CC genotype was
present in 86.8% and 67.5% (P = 0.002), the CT genotype was
present in 13.2% and 26.0% (P = 0.036), and the TT genotype
was present in 0% and 6.5% (P = 0.03) of southern and northern
Indians, respectively. The frequency of symptoms after the lactose
load (47.4% compared with 15.6%; P , 0.001) and peak concen-
trations of breath hydrogen (88.5 6 71.9 compared with 55.4 6
61.9 ppm; P = 0.003), both of which might indicate the degree of
lactase deficiency, were higher in southern than in northern Indians.
Conclusion: The frequency and degree of LM is higher in southern
than in northern Indian healthy populations because of genetic dif-
ferences in these populations. Am J Clin Nutr 2010;91:140–6.
INTRODUCTION
Lactose malabsor
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