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  • Title: Changes in small-intestine permeability with aging.
    Author: Saltzman JR, Kowdley KV, Perrone G, Russell RM.
    Journal: J Am Geriatr Soc; 1995 Feb; 43(2):160-4. PubMed ID: 7836641.
    Abstract:
    OBJECTIVE: To evaluate small-intestine mucosal integrity and permeability with advancing age as measured by the lactulose/mannitol absorption test in healthy subjects. DESIGN: Prospective cohort study. SETTING: Clinical research unit of the USDA Human Nutrition Research Center on Aging. STUDY PARTICIPANTS: Fifty-six subjects were recruited in three age groups: 20 to 39 years (n = 20), 40 to 59 years (n = 19), and > or = 60 years (n = 17). Subjects were healthy, community-dwelling volunteers. INTERVENTION: After an 8-hour fast, all subjects ingested 10 g of lactulose and 5 g of mannitol. Urine was collected for 6 hours and analyzed for lactulose and mannitol by high performance liquid chromatography. Twenty-four-hour urinary creatinine clearances were determined. MAIN OUTCOME MEASURES: Percentages of lactulose and mannitol excreted, the lactulose/mannitol ratio (x100), and the 24-hour creatinine clearance. RESULTS: With increasing age, both the percentage of lactulose excreted (P = 0.09) and the percentage of mannitol excreted (P = 0.05) tended to decrease progressively. The lactulose/mannitol ratio (x100) did not change with increasing age (P = 0.65) because both the percentages of lactulose and mannitol excreted declined. The creatinine clearance decreased markedly with advancing age (P < .001) and accounted for the decline in percentages of lactulose and mannitol excreted (P < .02). CONCLUSIONS: There is a progressive decline in the ability to excrete lactulose and mannitol with increasing age. This is probably attributable to a decline in renal function with advancing age. However, because of parallel decreases in lactulose and mannitol excretion, the lactulose/mannitol ratio does not change. Thus small-intestine "leakiness" does not increase with aging as measured by the lactulose/mannitol absorption test.
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