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- Title
A dual sugar challenge test for lipogenic sensitivity to dietary fructose.
- Authors
Hudgins, Lisa C; Parker, Thomas S; Levine, Daniel M; Hellerstein, Marc K
- Abstract
<bold>Context: </bold>Increased hepatic de novo lipogenesis (DNL) in response to dietary sugar is implicated in dyslipidemia, fatty liver, and insulin resistance.<bold>Objective: </bold>The aim of the study was to develop a simple outpatient tolerance test for lipogenic sensitivity to dietary sugar.<bold>Design and Setting: </bold>In inpatients given repeated doses of fructose, protocol 1 compared the acute increase in DNL determined from the percentage of palmitate ("new palmitate") and the percentage of isotopically labeled palmitate ("%DNL") in very low-density lipoprotein triglyceride (TG). Protocol 2 compared the increase in new palmitate in outpatients given three different sugar beverages in a randomized crossover design.<bold>Participants: </bold>There were 15 lean and overweight volunteers in protocol 1 and 15 overweight volunteers in protocol 2.<bold>Interventions: </bold>In protocol 1, subjects received 1.4 g/kg fructose in divided oral doses over 6 h; in protocol 2, subjects received 0.5 g/kg fructose, 0.5 g/kg fructose plus 0.5 g/kg glucose, or 1 g/kg fructose plus 1 g/kg glucose each as a single oral bolus.<bold>Main Outcome Measures: </bold>We measured the increase in DNL by two methods.<bold>Results: </bold>After repeated doses of fructose, new palmitate was significantly correlated with the increase in %DNL (Δ, r = 0.814; P < 0.001) and with fasting insulin levels (area under the curve, r = 0.754; P = 0.001). After a single sugar dose, new palmitate showed a dose effect and was greater after fructose plus glucose. Very low-density lipoprotein TG and total TG significantly increased in both protocols.<bold>Conclusions: </bold>A single oral bolus of fructose and glucose rapidly increases serum TG and TG palmitate in overweight subjects. A dual sugar challenge test could prove useful to identify individuals at risk for carbohydrate-induced dyslipidemia and other adverse effects of increased DNL.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2011, Vol 96, Issue 3, p861
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2010-2007