K. Deboeck et al., LIPID DIGESTION IN CYSTIC-FIBROSIS - COMPARISON OF CONVENTIONAL AND HIGH-LIPASE ENZYME THERAPY USING THE MIXED-TRIGLYCERIDE BREATH TEST, Journal of pediatric gastroenterology and nutrition, 26(4), 1998, pp. 408-411
Background: Fat maldigestion occurs in most patients with cystic fibro
sis. Conventional pancreatic enzyme replacement therapy partially corr
ects this defect. In this study, the mixed-triglyceride breath test wa
s used to evaluate whether high-lipase enzymes are equivalent to conve
ntional enzymes in improving fat maldigestion in children with cystic
fibrosis. Methods: Fat digestion was studied in 11 patients with a mea
n age of 10.5 years. The mean intake of conventional enzyme capsules a
day was 19. Four C-13 mixed-triglyceride tests were performed on sepa
rate days and in random order. One test was taken without enzyme subst
itution, one with three capsules of 8,000 FIP units Creon (pancreatinu
m, Kali-chemie Pharma, Hannover, Germany) and one with one capsule of
25,000 FLP units. The fourth test was made with C-13 octanoic acid to
study gastric emptying time. Results: Without enzyme intake, the mean
cumulative percentage of C-13 dose exhaled after 6 hours was 7.2 +/- 3
.7%. This increased to 14.4 +/- 4% with intake of conventional pancrea
tinum and to 14.3 +/- 5.1% with intake of high-lipase pancreatinum (p
= 0.0008 for both; paired t-test). There was no difference between bot
h treatments. Also, the time course of C-13 exhalation measured by per
centage of (CO2)-C-13 exhaled per hour did not differ between enzyme t
reatments. Conclusions: The C-13 mixed-triglyceride test is noninvasiv
e and documents improved lipid digestion with pancreatic enzyme replac
ement therapy. If the lipase dose is kept constant, results obtained w
ith high-lipase preparations are equivalent to those obtained with con
ventional preparations. (C) 1998 Lippincott-Raven Publishers.