Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045;
Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045.
Proc Natl Acad Sci U S A. 2018 Mar 20;115(12):3138-3143. doi: 10.1073/pnas.1713837115. Epub 2018 Mar 5.
Dietary guidelines for obesity typically focus on three food groups (carbohydrates, fat, and protein) and caloric restriction. Intake of noncaloric nutrients, such as salt, are rarely discussed. However, recently high salt intake has been reported to predict the development of obesity and insulin resistance. The mechanism for this effect is unknown. Here we show that high intake of salt activates the aldose reductase-fructokinase pathway in the liver and hypothalamus, leading to endogenous fructose production with the development of leptin resistance and hyperphagia that cause obesity, insulin resistance, and fatty liver. A high-salt diet was also found to predict the development of diabetes and nonalcoholic fatty liver disease in a healthy population. These studies provide insights into the pathogenesis of obesity and diabetes and raise the potential for reduction in salt intake as an additional interventional approach for reducing the risk for developing obesity and metabolic syndrome.
肥胖的饮食指南通常集中在三大类食物（碳水化合物、脂肪和蛋白质）和热量限制上。很少讨论非热量营养素的摄入，如盐。然而，最近有报道称高盐摄入可预测肥胖和胰岛素抵抗的发生。其作用机制尚不清楚。在这里，我们发现高盐摄入会激活肝脏和下丘脑的醛糖还原酶-果糖激酶途径，导致内源性果糖产生，从而导致瘦素抵抗和多食，引起肥胖、胰岛素抵抗和脂肪肝。高盐饮食还被发现可预测健康人群中糖尿病和非酒精性脂肪肝疾病的发生。这些研究为肥胖和糖尿病的发病机制提供了新的认识，并提出了减少盐摄入量作为降低肥胖和代谢综合征风险的额外干预措施的可能性。
