DeChristopher L R, Uribarri J, Tucker K L
Molecular Biology, NY Medical College, Valhalla, NY, USA.
Department of Medicine, Icahn School of Medicine, New York, NY, USA.
Nutr Diabetes. 2016 Mar 7;6(3):e199. doi: 10.1038/nutd.2016.7.
There is a link between joint and gut inflammation of unknown etiology in arthritis. Existing research indicates that regular consumption of high-fructose corn syrup sweetened (HFCS) soft drinks, but not diet soft drinks, may be associated with increased risk of seropositive rheumatoid arthritis (RA) in women, independent of other dietary and lifestyle factors. One unexplored hypothesis for this association is that fructose malabsorption, due to regular consumption of excess free fructose (EFF) and HFCS, contributes to fructose reactivity in the gastrointestinal tract and intestinal in situ formation of enFruAGEs, which once absorbed, travel beyond the intestinal boundaries to other tissues and promote inflammation. In separate studies, the accumulation of advanced glycation end-products has been associated with joint inflammation in RA. Objective of this study was to assess the association between EFF beverages intake and non-age, non-wear and tear-associated arthritis in US young adults.
In this cross sectional study of 1209 adults aged 20-30y, (Nutrition and Health Examination Surveys 2003-2006) exposure variables were high EFF beverages, including HFCS sweetened soft drinks, and any combination of HFCS sweetened soft drinks, fruit drinks (FD) and apple juice, referred to as tEFF. Analyses of diet soda and diet FD were included for comparison. The outcome was self-reported arthritis. Rao Scott Ҳ(2) was used for prevalence differences and logistic regression for associations, adjusted for confounders.
Young adults consuming any combination of high EFF beverages (tEFF) ⩾5 times/week (but not diet soda) were three times as likely to have arthritis as non/low consumers (odds ratios=3.01; p⩽0.021; 95% confidence intervals=1.20-7.59), independent of all covariates, including physical activity, other dietary factors, blood glucose and smoking.
EFF beverage intake is significantly associated with arthritis in US adults aged 20-30 years, possibly due to the intestinal in situ formation of enFruAGEs.
关节炎中关节炎症与肠道炎症之间存在病因不明的联系。现有研究表明，经常饮用高果糖玉米糖浆（HFCS）甜味软饮料而非无糖软饮料，可能会增加女性血清阳性类风湿关节炎（RA）的风险，且独立于其他饮食和生活方式因素。关于这种关联的一个未被探索的假说是，由于经常摄入过量游离果糖（EFF）和HFCS导致的果糖吸收不良，会促使胃肠道中的果糖发生反应，并在肠道原位形成晚期糖基化终产物（enFruAGEs），一旦被吸收，这些产物会越过肠道边界进入其他组织并引发炎症。在单独的研究中，晚期糖基化终产物的积累与RA中的关节炎症有关。本研究的目的是评估美国年轻成年人中EFF饮料摄入量与非年龄、非磨损相关关节炎之间的关联。
在这项对1209名20至30岁成年人的横断面研究中（2003 - 2006年营养与健康检查调查），暴露变量为高EFF饮料，包括HFCS甜味软饮料，以及HFCS甜味软饮料、果汁饮料（FD）和苹果汁的任意组合，称为总EFF（tEFF）。还纳入了无糖汽水和无糖FD的分析以作比较。结局为自我报告的关节炎。采用Rao Scott卡方检验（χ²）分析患病率差异，采用逻辑回归分析关联，并对混杂因素进行校正。
每周饮用高EFF饮料（tEFF）任意组合≥5次（但不包括无糖汽水）的年轻成年人患关节炎的可能性是非/低消费者的三倍（比值比 = 3.01；p≤0.021；95%置信区间 = 1.20 - 7.59），独立于所有协变量，包括身体活动、其他饮食因素、血糖和吸烟。
在美国20至30岁的成年人中，EFF饮料摄入量与关节炎显著相关，可能是由于肠道原位形成enFruAGEs所致。
