Biomedical Sciences, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research Biomedical Research Unit in Gastrointestinal and Liver Diseases at Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom.
Gastroenterology. 2013 Nov;145(5):1016-1025.e2. doi: 10.1053/j.gastro.2013.07.012. Epub 2013 Jul 19.
BACKGROUND & AIMS: Diets high in fructose have been proposed to contribute to nonalcoholic fatty liver disease. We compared the effects of high-fructose and matched glucose intake on hepatic triacylglycerol (TAG) concentration and other liver parameters.
In a double-blind study, we randomly assigned 32 healthy but centrally overweight men to groups that received either a high-fructose or high-glucose diet (25% energy). These diets were provided during an initial isocaloric period of 2 weeks, followed by a 6-week washout period, and then again during a hypercaloric 2-week period. The primary outcome measure was hepatic level of TAG, with additional assessments of TAG levels in serum and soleus muscle, hepatic levels of adenosine triphosphate, and systemic and hepatic insulin resistance.
During the isocaloric period of the study, both groups had stable body weights and concentrations of TAG in liver, serum, and soleus muscle. The high-fructose diet produced an increase of 22 ± 52 μmol/L in the serum level of uric acid, whereas the high-glucose diet led to a reduction of 23 ± 25 μmol/L (P < .01). The high-fructose diet also produced an increase of 0.8 ± 0.9 in the homeostasis model assessment of insulin resistance, whereas the high-glucose diet produced an increase of only 0.1 ± 0.7 (P = .03). During the hypercaloric period, participants in the high-fructose and high-glucose groups had similar increases in weight (1.0 ± 1.4 vs 0.6 ± 1.0 kg; P = .29) and absolute concentration of TAG in liver (1.70% ± 2.6% vs 2.05% ± 2.9%; P = .73) and serum (0.36 ± 0.75 vs 0.33 ± 0.38 mmol/L; P = .91), and similar results in biochemical assays of liver function. Body weight changes were associated with changes in liver biochemistry and concentration of TAGs.
In the isocaloric period, overweight men who were on a high-fructose or a high-glucose diet did not develop any significant changes in hepatic concentration of TAGs or serum levels of liver enzymes. However, in the hypercaloric period, both high-fructose and high-glucose diets produced significant increases in these parameters without any significant difference between the 2 groups. This indicates an energy-mediated, rather than a specific macronutrient-mediated, effect. Clinical trials.gov no: NCT01050140.
高果糖饮食被认为是导致非酒精性脂肪肝的原因之一。本研究旨在对比高果糖和等热量葡萄糖饮食对肝三酰甘油（TAG）浓度和其他肝脏参数的影响。
在这项双盲研究中，我们将 32 名健康但中心性超重的男性随机分配到高果糖或高葡萄糖饮食（25%能量）组。在最初的 2 周等热量期内，两组分别给予相应的饮食，随后进行 6 周的洗脱期，然后再次进入 2 周的高热量期。主要观察指标为肝 TAG 水平，同时评估血清和比目鱼肌的 TAG 水平、肝三磷酸腺苷（ATP）水平、全身和肝胰岛素抵抗。
在研究的等热量期内，两组的体重和肝、血清及比目鱼肌的 TAG 浓度均保持稳定。高果糖饮食使血清尿酸水平升高 22±52μmol/L，而高葡萄糖饮食使尿酸水平降低 23±25μmol/L（P＜.01）。高果糖饮食还使稳态模型评估的胰岛素抵抗增加 0.8±0.9，而高葡萄糖饮食仅增加 0.1±0.7（P=0.03）。在高热量期，高果糖和高葡萄糖组的体重增加相似（1.0±1.4 比 0.6±1.0 kg；P=0.29），肝 TAG 绝对浓度的增加也相似（肝组织 1.70%±2.6%比 2.05%±2.9%；P=0.73）和血清水平（0.36±0.75 比 0.33±0.38 mmol/L；P=0.91），肝功能生化检测也得到了相似的结果。体重变化与肝生化和 TAG 浓度的变化相关。
在等热量期，摄入高果糖或高葡萄糖饮食的超重男性肝 TAG 浓度或血清肝酶水平没有明显变化。然而，在高热量期，高果糖和高葡萄糖饮食均显著增加了这些参数，两组间无显著差异。这表明这种影响是由能量介导的，而不是特定的宏量营养素介导的。临床试验.gov 注册号：NCT01050140。
