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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 44 normal subjects, in 89 patients with chronic pancreatitis, of whom 23 had elevated faecal fat, and in 19 patients with various diseases of the small gut investigations with 14C-tripalmitate and 3H-palmitic acid, dissolved in 1.0 g Indian corn oil/kg, were performed. Serum lipid activity of 14C and 3H was measured 4, 6, and 8 h later. Compared with absolute values of triglyceride absorption (percentage dose of 14C-lipid activity/l serum), relative values (14C/3H ratio of the serum lipids) led to a significantly better discrimination between the control group and patients, attributable to a much smaller normal range. Compared with fatty acid absorption, triglyceride absorption was lowered in all cases of pancreatic steatorrhoea, in most cases of chronic pancreatitis, and in some cases of intestinal malabsorption. While the proposed procedure seems to be sensitive and reliable in the detection of maldigestion, a distinction between maldigestion and malabsorption is apparently uncertain.
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PMID:Diagnosis of fat absorption with 14C-tripalmitate/3H-palmitic acid. 49 49

An attempt was made to evaluate the diagnostic effectiveness of the 14CO2-tripalmitin breath test in the screening or diagnosis of fat malabsorption. The differential absorption of 14C-tripalmitin and palmitic acid was evaluated in the diagnosis of pancreatic insufficiency. 24 controls, 13 patients with steatorrhea and 6 with pancreatic disease (4 of them with sufficiency) were studied. 81 breath tests were performed using 75 ml sour cream as a carrier. In 11 cases the 14C-tripalmitin test was repeated using 27 g corn oil as carrier. Both the 14C-tripalmitin and 14C-palmitic acid breath tests failed to provide any discrimination between normals and patients with fat malabsorption. Variation in type and amount of the carrier fat did not alter these results. 14C-tripalmitin absorption was distinctly abnormal in the patients with pancreatic insufficiency. The differential absorption of 14C-tripalmitin and 14C-palmitic acid provided an even better separation between patients with and without pancreatic disease. In contrast to some other investigators we did not find the 14C-tripalmitin and/or palmitic acid breath tests useful in the diagnosis or screening of fat malabsorption. These tests appear promising in the diagnosis of pancreatic disease.
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PMID:Is the fat breath test effective in the diagnosis of fat malabsorption and pancreatic disease? 72 47

To develop criteria for deficiency of essential fatty acids (EFA), we used capillary-column gas-liquid chromatography to determine fatty acids (percentage of total fatty acids) in plasma obtained in the fasting state from 56 reference subjects and from 10 patients with intestinal fat malabsorption and suspected EFA deficiency. Fatty acid evaluations (percentage of total fatty acids) that allowed for a clear distinction (P less than 0.01) between reference subjects and patients, based on values two standard deviations below or above the reference mean, included values for linoleic acid (18:2w6) below 27%, and values for palmitic acid (16:0), palmitoleic acid (16:1w7), oleic acid (18:1w9), vaccenic acid (18:1w7), and Mead acid (20:3w9) exceeding 21%, 2.6%, 23.3%, 2.1%, and 0.21%, respectively. Ratios of total EFA to total non-EFA of less than 0.60 and of Mead acid to arachidonic acid of greater than 0.025 also served to identify patients, and were not found in reference subjects. Significant inverse correlations between percentages of plasma EFA and plasma mono-unsaturated fatty acids were noted. Our reference-interval data can be used to assess normality of plasma EFA status.
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PMID:Criteria for essential fatty acid deficiency in plasma as assessed by capillary column gas-liquid chromatography. 366 42

Three substrates labeled with nonradioactive 13C have been employed to establish a trilogy of noninvasive breath tests to detect fat malabsorption in children and then to differentiate the etiology of the steatorrhea. Administration of 17 mg/kg of (13C)triolein Lipomul (The Upjohn Co., Kalamazoo, Mich.) resulted in a peak excretion rate of 13CO2 greater than 2.7% dose/h in 10 normal subjects (mean value 4.96 +/- 2.2% dose/h) whereas all 17 subjects with fat malabsorption were below this value (mean value, 0.75% +/- 0.63% dose/h); p less than 0.001). For the detection of fat malabsorption, the discriminative value of (13C)triolein was superior, 100% sensitive, and 89% specific, while the use of (13C)palmitic acid (17 mg/kg) or (13C)trioctanoin (7.5 mg/kg) alone yielded both false-positive and false-negative results. In 6 out of 6 cases, pancreatic insufficiency could be differentiated from mucosal disease (7 patients) or bile salt deficiency (4 patients) by the presence of abnormal triolein or trioctanoin breath tests, or both but normal palmitic acid breath tests. However, further differentiation of mucosal disorders from bile salt disorders could not be achieved using either a single- or a multiple-substrate breath test. The use of the single triolein breath test in children offers an attractive, sensitive alternative to conventional fecal fat measurements to establish the presence of steatorrhea, and when using 12C-lipid with multiple substrates, the tests are capable of providing additional insight into the mechanism of fat malabsorption.
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PMID:Diagnosis and differentiation of fat malabsorption in children using 13C-labeled lipids: trioctanoin, triolein, and palmitic acid breath tests. 706 Sep 13

A vegetable oil fat blend resulting in formula major fatty acid levels similar to human milk is appropriate for infant feedings even though the palmitic acid may have a somewhat different positional distribution. Growth, bone mineral content, and visual acuity (as measured by the Teller acuity card procedure) achieved in normal infants consuming such formulas are at least as good as those from human milk. The quantitatively minor LC-PUFA levels may also be important in infant development and useful once safety of their sources has been adequately demonstrated. Such formula fat blends mimicking the major fatty acid profiles of human milk are appropriate for infants with relatively normal fat absorptive mechanisms including infants with allergy or inborn errors of metabolism. Formulas designed for such infants (e.g., extensively hydrolyzed protein products for allergic infants) do not need to have MCT oil included in the formulation which alters the fatty acid profile. On the other hand, those infants with immaturity, gastrointestinal disease, and/or fat malabsorption often do benefit by the inclusion of MCT oil in the fat blend of the formula.
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PMID:Challenges of matching human milk fatty acid patterns technically and functionally. 908 18

A common feature of cystic fibrosis (CF) is the functional derangement of the exocrine pancreas, which affects output of pancreatic lipase. This condition results in severe dietary malabsorption due to the poor hydrolysis of triacylglycerol (TG) in the lumen of the small intestine. Despite the benefits of pancreatic enzyme supplements, patients with CF present with persistent intestinal fat malabsorption. The aim of the present investigation was to determine whether defects in the intracellular phase of lipid transport occur in this pathophysiology in addition to the known disturbed digestive processes. Our hypothesis was tested by incubating intestinal biopsies from six CF and six healthy subjects with radiolabeled lipid and protein precursors. Lipid esterification and secretion were markedly decreased by 22-31% and 38-42%, respectively, in CF samples, as noted by the low incorporation of [(14)C]palmitic acid into TGs, phospholipids, and cholesteryl esters in patients' duodenal explants and culture media compared with controls (100%). Accordingly, the output of TG-rich lipoproteins was substantially reduced (P < 0.05), and a similar trend was observed for high-density lipoproteins. Because intestinal lipoprotein assembly/secretion shows an absolute requirement for apolipoprotein (apo) B-48, radioactive labeling experiments were performed; these experiments demonstrated a significantly (P < 0.05) diminished synthesis of apoB-48 (40%) and apoA-I (30%). Given the critical role of microsomal triglyceride transfer protein in the formation of apoB-containing lipoproteins, its activity was determined and not found to be altered in CF intestinal tissue. Together, these results suggest that CF malabsorption may also be caused by defects in mucosal mechanisms leading to abnormal lipoprotein delivery into the blood circulation.
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PMID:Abnormal intracellular lipid processing contributes to fat malabsorption in cystic fibrosis patients. 1622 44