Study design (if review, criteria of inclusion for studies)
RCT
Participants
6 adult CF patients both with and without pancreatic enzyme replacement therapy (PERT). Studies were also performed in 8 healthy volunteers
Interventions
Subjects drank 50 mL of a liquid meal mixed with 200 microL 13C-triolein and breath samples were collected by blowing through a straw into collection tubes every 30 min for 6 h.
Outcome measures
13CO2 recovery after an overnight fast in patients with CF in the usual dose for a light snack, in a randomized order, on different days. Studies were also performed in healthy volunteers after oral ingestion. The effect of gastric emptying was assessed by comparison of oral ingestion with intraduodenal infusion. Intra-individual variability was assessed in volunteers by repeating the breath test after drinking the test meal on a separate day
Main results
Compared with healthy subjects there was virtually no recovery of 13CO2 in CF patients without PERT. The median (interquartile range) cumulative percentage dose recovery (cPDR) at 6 h was 3% (0-8) in CF patients compared with 28% (22-41) in healthy controls (P < 0.01). Fat absorption was normalized (37%) (36-43) after ingestion of PERT. Gastric emptying delayed the peak in 13CO2 recovery, but there was no difference in the cPDR at 6 h. There was no difference in recovery between days 1 and 2.
Authors' conclusions
The 13C-triolein breath test is a simple and reproducible method to measure fat malabsorption. The test provides a screening technique for fat malabsorption in adult CF patients and may be useful for monitoring the lowest effective dose of PERT.