Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland.
Diabetes Care. 2013 Jan;36(1):150-6. doi: 10.2337/dc12-0540. Epub 2012 Aug 28.
Adverse effects of hypercaloric, high-fructose diets on insulin sensitivity and lipids in human subjects have been shown repeatedly. The implications of fructose in amounts close to usual daily consumption, however, have not been well studied. This study assessed the effect of moderate amounts of fructose and sucrose compared with glucose on glucose and lipid metabolism.
Nine healthy, normal-weight male volunteers (aged 21-25 years) were studied in this double-blind, randomized, cross-over trial. All subjects consumed four different sweetened beverages (600 mL/day) for 3 weeks each: medium fructose (MF) at 40 g/day, and high fructose (HF), high glucose (HG), and high sucrose (HS) each at 80 g/day. Euglycemic-hyperinsulinemic clamps with [6,6]-(2)H(2) glucose labeling were used to measure endogenous glucose production. Lipid profile, glucose, and insulin were measured in fasting samples.
Hepatic suppression of glucose production during the clamp was significantly lower after HF (59.4 ± 11.0%) than HG (70.3 ± 10.5%, P < 0.05), whereas fasting glucose, insulin, and C-peptide did not differ between the interventions. Compared with HG, LDL cholesterol and total cholesterol were significantly higher after MF, HF, and HS, and free fatty acids were significantly increased after MF, but not after the two other interventions (P < 0.05). Subjects' energy intake during the interventions did not differ significantly from baseline intake.
This study clearly shows that moderate amounts of fructose and sucrose significantly alter hepatic insulin sensitivity and lipid metabolism compared with similar amounts of glucose.
高热量、高果糖饮食对人体胰岛素敏感性和脂质的不良影响已被反复证实。然而，对于接近日常摄入量的果糖的影响，尚未进行很好的研究。本研究评估了与葡萄糖相比，适量的果糖和蔗糖对葡萄糖和脂质代谢的影响。
本双盲、随机、交叉试验纳入了 9 名健康、体重正常的男性志愿者（年龄 21-25 岁）。所有受试者均饮用 4 种不同的甜味饮料（600 mL/天），每种饮料持续 3 周：中果糖（MF）40 g/天，高果糖（HF）、高葡萄糖（HG）和高蔗糖（HS）各 80 g/天。采用[6,6]-(2)H(2)葡萄糖标记的正葡萄糖-高胰岛素钳夹技术测量内源性葡萄糖生成。在禁食样本中测量血脂谱、血糖和胰岛素。
HF 组（59.4±11.0%）钳夹期间肝葡萄糖生成抑制明显低于 HG 组（70.3±10.5%，P<0.05），而禁食血糖、胰岛素和 C 肽在干预组之间无差异。与 HG 组相比，MF、HF 和 HS 组的 LDL 胆固醇和总胆固醇明显升高，MF 组的游离脂肪酸明显升高，但 HF 和 HS 组无明显升高（P<0.05）。干预期间受试者的能量摄入量与基线摄入量无显著差异。
本研究清楚地表明，与等量的葡萄糖相比，适量的果糖和蔗糖会显著改变肝胰岛素敏感性和脂质代谢。
