High Fructose Consumption Impairs Liver Function

Obese patients with type 2 diabetes who increased their habitual dietary fructose consumption experienced reduced hepatic adenosine triphosphate concentrations…. 

According to data from an observational, cross-sectional study of the NIH-sponsored Look Ahead Fatty Liver Ancillary Study, obese patients with type 2 diabetes who increased their habitual dietary fructose consumption experienced reduced hepatic adenosine triphosphate concentrations compared with those who consumed less,

The researchers wrote, “These data support our hypothesis that increased dietary fructose consumption may impair hepatocellular energy homeostasis and thus could be a risk factor for progressive liver injury. Further, hyperuricemia may serve as a surrogate marker of hepatic [adenosine triphosphate] depletion following exposure to fructose in patients with [insulin resistance], and potentially [nonalcoholic fatty liver disease].”

Manal F. Abdelmalek, MD, MPH, an associate professor of medicine in the division of gastroenterology at Duke University Medical Center, and colleagues evaluated 244 adults with type 2 diabetes aged 45 to 76 years who were eligible to participate in the study at Johns Hopkins University.

Patients underwent a 130-item food frequency questionnaire to estimate their dietary fructose consumption; researchers also collected uric acid (UA) levels and measured hepatic adenosine triphosphate (ATP) using phosphorus magnetic resonance spectroscopy. A subcategory of patients (n=25) underwent an IV fructose challenge test, the researchers wrote.

Data from the study showed high dietary fructose consumers had “slightly lower baseline hepatic ATP levels and a greater absolute change in hepatic alpha-ATP/Pi ratio (0.08 vs. 0.03, P=.05) and gamma-ATP/P_i ratio, following an intravenous fructose challenge (0.03 vs. 0.06, P=.06). Additionally, patients with high UA levels (≥5.5 mg/dL) showed a lower minimum liver ATP/Pi ratio after the intravenous fructose challenge (4.5 vs. 7, P=.04),” the researchers wrote.

From the results, it was concluded that, impaired hepatic energy homeostasis marks an urgent need for increased public awareness of risks related to high fructose consumption.

Hepatology, May 2012, DOI: 10.1002/hep.25741