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- Title
Children with NAFLD are more sensitive to the adverse metabolic effects of fructose beverages than children without NAFLD.
- Authors
Jin R; Le NA; Liu S; Farkas Epperson M; Ziegler TR; Welsh JA; Jones DP; McClain CJ; Vos MB; Jin, Ran; Le, Ngoc-Anh; Liu, Shuling; Farkas Epperson, Monica; Ziegler, Thomas R; Welsh, Jean A; Jones, Dean P; McClain, Craig J; Vos, Miriam B
- Abstract
<bold>Context: </bold>Dietary fructose induces unfavorable lipid alterations in animal models and adult studies. Little is known regarding metabolic tolerance of dietary fructose in children.<bold>Objectives: </bold>The aim of the study was to evaluate whether dietary fructose alters plasma lipids in children with nonalcoholic fatty liver disease (NAFLD) and in healthy children.<bold>Design and Setting: </bold>We performed a 2-d, crossover feeding study at the Inpatient Clinical Interaction Site of the Atlanta Clinical and Translational Science Institute at Emory University Hospital.<bold>Participants and Intervention: </bold>Nine children with NAFLD and 10 matched controls without NAFLD completed the study. We assessed plasma lipid levels over two nonconsecutive, randomly assigned, 24-h periods under isocaloric, isonitrogenous conditions with three macronutrient-balanced, consecutive meals and either: 1) a fructose-sweetened beverage (FB); or 2) a glucose beverage (GB) being consumed with each meal.<bold>Main Outcome Measures: </bold>Differences in plasma glucose, insulin, triglyceride, apolipoprotein B, high-density lipoprotein cholesterol, and nonesterified free fatty acid levels were assessed using mixed models and 24-h incremental areas under the time-concentration curve.<bold>Results: </bold>After FB, triglyceride incremental area under the curve was higher vs. after GB both in children with NAFLD (P = 0.011) and those without NAFLD (P = 0.027); however, incremental response to FB was greater in children with NAFLD than those without NAFLD (P = 0.019). For all subjects, high-density lipoprotein cholesterol declined in the postprandial and overnight hours with FB, but not with GB (P = 0.0006). Nonesterified fatty acids were not impacted by sugar but were significantly higher in NAFLD.<bold>Conclusions: </bold>The dyslipidemic effect of dietary fructose occurred in both healthy children and those with NAFLD; however, children with NAFLD demonstrated increased sensitivity to the impact of dietary fructose.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2012, Vol 97, Issue 7, pE1088
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2012-1370