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Intake of Sugars Correlates with the Rise in Obesity and Diabetes

Oct 10, 2013

Fructose-induced hyperuricemia may contribute to type 2 diabetes…. 

Recent studies have shown that fructose may contribute to hyperuricemia, insulin resistance, and diabetes. Fructose has various effects on the body’s systems such as the hepatic, adipose tissues and vasculature. With increasing evidence, it is suggested that uric acid plays a role in the metabolic syndrome. Uric acid can cause mitochondrial oxidative stress which would stimulate fat accumulation.

In the hepatic, uric acid can induce mitochondrial oxidative stress. The oxidative stress drives insulin resistance. Within the adipose tissue, uric acid may induce insulin resistance. Uric acid is taken up by anion transporters in adipocytes. This is where oxidative stress occurs via activation of NADPH oxidase. In the vasculature, insulin stimulates the release of NO from endothelial cells. This causes vasodilation and the delivery of glucose to the skeletal muscle. In the presence of uric acid, endothelial NO is inhibited due to insulin resistance.

A meta-analysis argues that fructose is not a factor that causes weight gain. Weight gain happens when there is an increased energy intake rather than a reduction in metabolic rate. Fructose can increase weight by stimulating hunger and blocking satiety responses. So if food intake is well controlled, weight gain would not be observed.

Uric acid has other functions such as being an antioxidant in the extracellular environment or improving endothelial function. It is suggested that uric acid may not be the one driving the metabolic syndrome. Some believe it is xanthine oxidase that may be responsible for the metabolic syndrome. The author concluded that more studies are needed to provide more information about fructose-induced hyperuricemia. There could be possible arguments about how genetics can play a role in uric acid and fructose metabolism.

Practice Pearls:

  • Fructose intake induces metabolic syndrome.
  • Fructose stimulates uric acid synthesis.
  • Uric acid can induce mitochondrial oxidative stress.

Diabetes Care October 2013.