The influence of age on the xylose absorption test

Kendall, M. J.

doi:10.1136/gut.11.6.498

Cited by 62 publications

(26 citation statements)

References 8 publications

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“…No subject exceeded AGEING AND GLUCOSE HOMEOSTASIS 841 Values shown are the mean ± SEM; number in parentheses are the range. " n = 9 in group Y, 10 in group M, 7 in group E. 6 Mean levels are not significantly different for groups, Y, M, and E.…”

Section: Methodsmentioning

confidence: 90%

“…There is general agreement, however, that the insulin response to glucose and insulinglucagon relationships do not change appreciably with age (1,2). Furthermore, since both oral and iv glucose tolerance are similarly affected by age, changes in absorption are unlikely to play a major role (1,(3)(4)(5)(6). Previous authors (7,8) have studied tissue responsiveness to insulin and glucose disposal using the hyperglycemic and euglycemic clamp techniques but their conclusions are conflicting.…”

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confidence: 87%

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Influence of Ageing on Glucose Homeostasis*

Jackson

Blix

Matthews

et al. 1982

The Journal of Clinical Endocrinology & Metabolism

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The mechanism of age-related glucose intolerance was investigated by comparing forearm glucose uptake (FGU) during 100-g oral glucose tolerance tests (GTTs) in healthy men of different ages: group Y, 19-24 yr (n = 11); group M, 30-45 yr (n = 12); and group E, 70-83 yr (n = 9).Progressive elevation of the glucose tolerance curve occurred with increasing age, the curve of each group differing from the others at all points from 60-180 min. Although with age absolute levels of FGU were not reduced, the rise in FGU per incremental change in arterial plasma glucose concentration was significantly decreased, whereas the corresponding relationship between FGU and serum insulin was less marked. Early insulin responses were similar in all age groups, but after 60 min the curves diverged in a pattern corresponding to the respective glucose responses and differed significantly from 150-180 min. The relative changes in insulin levels corresponded to those observed in C-peptide concentrations in all groups. C-peptide to insulin ratios were not influenced by age. Similar proportions of proinsulin in total immunoreactive insulin were found in elderly subjects and men from group M.No difference in monocyte insulin receptor numbers or affinity was observed in elderly men and subjects from group M. Basal FFA levels were significantly higher in the elderly than in group Y and fell rapidly after glucose loading in all groups.Arterial lactate concentrations increased after glucose loading in all groups, but in the elderly the rise was significantly delayed.In order to compare FGU in these groups at similar arterial glucose levels rather than at the differing concentrations observed after glucose loading, GTTs were repeated in five subjects from group M. During these studies additional glucose was infused intermittently from 30-180 min in order to simulate the raised arterial glucose concentrations noted in the elderly. This required a mean infusion of 62.3 g (range, 33.4-97.7 g) and increased FGU to a level 3-fold greater than that observed in the elderly. To determine whether any reserve for further increasing overall glucose disposal is retained in the elderly, GTTs were repeated in three older men, in each of whom additional glucose infusions raised the 60-min concentrations by 50 mg/dl. In each of these subjects the subsequent fall in arterial glucose levels was accelerated.The results suggest that impaired peripheral glucose uptake is an important mechanism resulting in age-related glucose intolerance. At similar glucose and insulin concentrations, peripheral glucose uptake in the elderly is only one-third that in younger men. Since insulin receptor binding was not reduced in the elderly, this impairment may be a postreceptor phenomenon. (J Clin Endocrinol Metab 55: 840, 1982)

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Section: Methodsmentioning

confidence: 90%

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confidence: 87%

Influence of Ageing on Glucose Homeostasis*

Jackson

Blix

Matthews

et al. 1982

The Journal of Clinical Endocrinology & Metabolism

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“…Kendall (10) suggested that the absorption of xylose (5 g) was unimpaired in older subjects, but Webster and Leeming (11) demonstrated reduced xylose absorption in 26% of patients >63 yr when the aged small bowel was more adequately stressed by administration of 25 g xylose. Furthermore, with breath-hydrogen analysis to detect intestinal-carbohydrate malabsorption, recent studies revealed impaired absorption in one-third of subjects >65 yr after a 100-g carbohydrate meal and in two-thirds of elderly subjects after a 200-g carbohydrate meal (12).…”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, controversy remains with regard to the influence of aging on glucose absorption. Although some authors have suggested that glucose absorption is unaffected by aging (9,10), other investigators have reported a significant reduction in intestinal glucose absorption in the elderly (11)(12)(13).…”

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confidence: 98%

Influence of Aging on Hepatic and Peripheral Glucose Metabolism in Humans

Jackson

Hawa²,

Roshania³

et al. 1988

Diabetes

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Mechanisms of glucose intolerance with aging were studied by comparing the metabolic response to glucose ingestion in 10 young (20-23 yr) and 10 elderly (73-80 yr) normal men with the simultaneous application of the forearm and double-isotope techniques. The latter technique consisted of a primed-constant infusion of [3-3H]glucose followed by the administration of an oral glucose load (mean +/- SE, 90.7 +/- 0.7 g) containing [1-14C]glucose. Fasting plasma glucose and insulin concentrations were similar in young and elderly subjects, but in the elderly, glucose tolerance was markedly impaired. Although in the elderly the initial rise in insulin levels (delta, i.e., the incremental area under the curve) from 0 to 30 min was delayed (P less than .02), the response from 0 to 45 min, 0 to 60 min, and thereafter equaled that in the young group, and from 90 to 240 min insulin concentrations in the elderly exceeded those in young subjects. Basal hepatic glucose output (HGO) was similar in young and elderly men (2.13 +/- 0.10 and 1.97 +/- 0.14 mg.kg-1.min-1, respectively). Similar proportional reductions in HGO from 0 to 270 min after glucose loading occurred in young (59.7 +/- 10.3%) and elderly (50.3 +/- 4.9%) subjects but was delayed in the elderly. Suppression of HGO was observed in the young 30 min after glucose ingestion (P less than .02), but not before 60 min in the elderly subjects (P less than .05). The systemic appearance of ingested glucose (0-270 min) was slowed with age (80.7 +/- 3.1 and 66.9 +/- 4.3% of the oral load in the young and elderly groups, respectively; P less than .02). Initial increments in both total glucose disappearance (Rd) and forearm glucose uptake (FGU) from 0 to 60 min after glucose loading were decreased in the elderly (Rd, 4.1 +/- 0.7 vs. 11.5 +/- 1.3 g, P less than .001; FGU, 17.2 +/- 1.4 vs. 24.6 +/- 2.5 md/dl forearm, P less than .02). The overall increment (delta, 0-270 min) in Rd was reduced with age (47.2 +/- 2.9 and 34.5 +/- 3.6 g, P less than .02 in the young and elderly, respectively), but the corresponding data for FGU were similar in the two groups.(ABSTRACT TRUNCATED AT 400 WORDS)

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“…4,27 In a few studies, the mean value of Dxylose estimated in urine using colorimetry was found to be in an abnormally low range with 5 g D-xylose in healthy subjects. 28,29 Therefore, low specificity of colorimetry is quite expected. We used 5 g D-xylose instead of 25 g as the former is popular, devoid of side effects like nausea and diarrhea, more acceptable for children and is cheaper compared with 25 g D-xylose.…”

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confidence: 99%

¹H NMR spectroscopic method for diagnosis of malabsorption syndrome: a pilot study

et al. 2004

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Despite its well-documented limitations, colorimetry has been commonly used for the d-xylose test in the diagnosis of malabsorption syndrome (MAS). With a possibility of overcoming its limitations, the use of (1)H NMR spectroscopy for D-xylose test is explored herein. Urine samples from 35 adults with suspected MAS were obtained before and after oral ingestion of D-xylose. The diagnosis of MAS was based on fecal fat (72 h excretion using Van de Kamer's technique, normal < 7 g/24 h and/or Sudan III stain of spot stool specimen, normalor=1 g/5 g/5 h). In vitro experiments on the standard specimens of D-xylose were also performed independently using both methods. Colorimetry showed a lower value for the quantity of D-xylose excreted in urine than NMR [median 0.73 (0.17-1.89 g) vs 1.37 (0.17-3.23 g), respectively; p<0.0001, Wilcoxon's signed ranks test]. Colorimetry and NMR correctly diagnosed 11/12 and 10/12 (p=N.S.) patients with MAS and 14/23 and 20/23 (p<0.05) without MAS, respectively. Sensitivity and specificity of colorimetry and NMR were 91.6 and 60.7% vs 83.3 and 86.9%, respectively. In in vitro experiments, the values obtained for standard xylose using NMR showed a maximum error of 7%, whereas the colorimetric method showed 20%. The NMR method is simple and may be more accurate for the D-xylose absorption test. Colorimetry was found to be inferior as compared with NMR due to its low specificity.

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The influence of age on the xylose absorption test

Cited by 62 publications

References 8 publications

Influence of Ageing on Glucose Homeostasis*

Influence of Ageing on Glucose Homeostasis*

Influence of Aging on Hepatic and Peripheral Glucose Metabolism in Humans

¹H NMR spectroscopic method for diagnosis of malabsorption syndrome: a pilot study

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The influence of age on the xylose absorption test

Cited by 62 publications

References 8 publications

Influence of Ageing on Glucose Homeostasis*

Influence of Ageing on Glucose Homeostasis*

Influence of Aging on Hepatic and Peripheral Glucose Metabolism in Humans

1H NMR spectroscopic method for diagnosis of malabsorption syndrome: a pilot study

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Product

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¹H NMR spectroscopic method for diagnosis of malabsorption syndrome: a pilot study