Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. May 6, 2016; 7(2): 283-293
Published online May 6, 2016. doi: 10.4292/wjgpt.v7.i2.283
Disaccharidase activity in children undergoing esophagogastroduodenoscopy: A systematic review
Taylor Daileda, Peter Baek, Morgan E Sutter, Kalpesh Thakkar
Taylor Daileda, Peter Baek, Morgan E Sutter, Kalpesh Thakkar, the SONIC Gut Research Group, Houston, TX 77479, United States
Author contributions: Daileda T, Sutter ME and Thakkar K contributed to the collection of data, study design, analysis of data, drafting the manuscript, and editing the manuscript; Baek P and contributed to the collection of data, study design, and editing the manuscript; Sutter ME contributed to the study design and editing the manuscript; all authors approved the final version of the manuscript.
Conflict-of-interest statement: No funding or conflicts of interest to report.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Dryad repository, will provide a permanent, citable and open-access home for the dataset. All data for this systematic review was gathered from included studies.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kalpesh Thakkar, MD, the SONIC Gut Research Group, 1803 Cambria Lane, Sugar Land, Houston, TX 77479, United States. thakkarsmail@gmail.com
Telephone: +1-281-7255970 Fax: +1-281-7255971
Received: July 24, 2015
Peer-review started: July 27, 2015
First decision: August 25, 2015
Revised: January 15, 2016
Accepted: January 27, 2016
Article in press: January 29, 2016
Published online: May 6, 2016
Abstract

AIM: To investigate the utility of intestinal disaccharide analysis during esophagogastroduodenoscopy (EGD) in children, we performed a systematic review of studies examining disaccharide activity.

METHODS: All full-length articles published in English during 1966-2014 were included if: (1) participants had small intestinal biopsy evaluation of disaccharide activity; (2) levels of lactase, sucrase, maltase or palatinase were reported; and (3) age of participants was under 18 years.

RESULTS: Thirty articles examining 34753 disaccharide assays fulfilled the specific search, inclusion, and exclusion criteria. All of the studies were observational in design and 57% (17) were prospective. Sixteen studies were conducted in the United States and 9 European studies were identified. The biggest study enrolled about 30, 314 procedures and 13 studies investigated fewer than 50 procedures. Eleven studies examined Caucasian subjects, 3 studies examined Asian subjects, and 6 examined African subjects. Only one Hispanic subject was included. In studies reporting disaccharide deficiency, the overall proportion of lactase deficiency was 39.2%, sucrase deficiency was 9.0%, maltase deficiency was 12.6% and palatinase deficiency was 9.1%. The prevalence of duodenal inflammatory changes ranged from 6% to 24% for non-specific histological lesions (e.g., duodenitis). Sixteen studies examined the association of histologic findings with disaccharide activities, and 12 studies reported an inverse association between degree of histologic inflammation and disaccharide levels.

CONCLUSION: We reviewed 30 studies including 34753 biopsy specimens with disaccharide analysis from children undergoing EGD. Our findings advocate a large study is to further illuminate the importance of EGD with disaccharide analysis in children.

Keywords: Disaccharidase, Endoscopy, Children

Core tip: Intestinal disaccharide analysis of duodenal biopsy specimens are often obtained during esophagogastroduodenoscopy (EGD) in children. In our review examining 34753 disaccharide assays the overall proportion of lactase deficiency was 39.2%, sucrase deficiency was 9.0%, maltase deficiency was 12.6% and palatinase deficiency was 9.1% in children. The impact of EGD with disaccharide analysis on treatment plans, quality of life, improvement of gastrointestinal symptoms, and cost-effectiveness has not been well studied. There is also little published data on Hispanic children undergoing EGD with disaccharide analysis.