Background: In this study we have looked at the reliability
of a multi-sugar test in a pediatric patient population and
its accuracy at small urine volumes to evaluate intestinal
permeability.
Methods: Out of 117 subjects enrolled, 31 were healthy
and 86 were sick. A solution containing lactulose, rhamnose,
sucrose, and sucralose was administered to subjects
who were on fasting; the urine excreted during 5 h was
collected and measured. Samples were analyzed by gas
chromatography-tandem mass spectrometry and results
were expressed as percentage of sugar recoveries and lactulose/
rhamnose (L/R) ratio.
Results: The analyses showed a clear effect of low urinary
volumes ( £ 240 mL) particularly affecting rhamnose
excretion in healthy subjects and sucrose and sucralose
recovery in diseased children. Despite the low rhamnose
recovery, as lactulose is not similarly affected, the diagnostic
reliability of L/R ratio is well preserved at low
diuresis conditions. However, this ratio can be useful to
discriminate acute conditions vs. clinical remissions only
at high urine volumes. Data also suggest potential diagnostic
applicability of sucrose and sucralose in children
at high urine volumes.
Conclusions: In conclusion, the multi-sugar test has a
good predictivity in pediatric subjects but results must be
carefully interpreted in the face of reduced diuresis.
