Dig Dis Sci. 2008 Mar 5 [Epub ahead of print]

Lactulose/Mannitol Test and Specificity, Sensitivity, and Area under Curve of Intestinal Permeability Parameters in Patients with Liver Cirrhosis and Crohn's Disease.

Dastych M, Dastych M Jr, Novotná H, Cíhalová J. Department of Clinical Biochemistry and Hematology, University Hospital Brno, Jihlavská 20, 62500, Brno, Czech Republic, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .

The purpose of this study was to investigate and compare the specificity, sensitivity, and area under curve (AUC) of the lactulose/mannitol ratio, lactulose/creatinine ratio, and lactulose recovery and their diagnostic value for intestinal permeability assessment within the absorption lactulose/mannitol (L/M) test. Results The value of the lactulose/mannitol ratio, lactulose/creatinine ratio, and the percentage of lactulose recovery in Crohn's disease (0.0763 +/- 0.0369; 99.62 +/- 67.87; 1.0478 +/- 0.6148) and in liver cirrhosis (0.0517 +/- 0.0365; 54.65 +/- 53.26; 0.838 +/- 0.929) were significantly different from the values measured in the control group (0.0123 +/- 0.0081; 10.95 +/- 7.07; 0.2438 +/- 0.1568), P < 0.0001-0.002). In Crohn's disease, specificity, sensitivity, and AUC were 100%, 89.5%, and 0.987, respectively, of the lactulose/mannitol ratio at a cut-off level of 0.022. In liver cirrhosis, the test characteristics were 88.5%, 84.2%, and 0.910 at a cut-off level of 0.018. Conclusion The lactulose/mannitol ratio was evaluated to have the highest diagnostic value to assess intestinal permeability.

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