Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Division of Renal Medicine M99, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
Eur J Clin Invest. 2019 Jan;49(1):e13040. doi: 10.1111/eci.13040. Epub 2018 Nov 16.
Fructose intake may lead to hyperuricaemia, which is associated with increased risk and progression of kidney disease. We aimed to explore the acute effects of fructose loading from different sources, with and without a pizza, on levels of serum uric acid in patients with chronic kidney disease (CKD), type 2 diabetes (T2D) without CKD, and in healthy subjects (HS).
The study included six HS, and three CKD stage 4-5 and seven T2D patients. Drinks consumed were blueberry drink (17.5 g fructose), Coca-Cola (18 g fructose) and fructose drink (35 g fructose). The drinks were also combined with pizza, in total six interventions. Serum samples were collected fasting and 30, 60, 90 and 120 minutes after intake and also 240 minutes after drink + pizza, and analysed for fructose, uric acid and triglycerides. Postprandial responses were explored using repeated-measure ANOVA.
Baseline serum uric acid levels were increased in CKD (P = 0.037). There were significant differences in serum fructose and serum uric levels over time between drinks and drinks + pizza for all groups (P < 0.001 and P < 0.05, respectively). The highest peak in serum fructose followed the fructose drink interventions and the lowest the blueberry drink. The fructose drink interventions gave the highest responses in serum uric acid and the lowest responses followed the blueberry drink. Triglycerides increased following pizza interventions (P < 0.001).
Intake of fructose increases serum uric acid. The fructose intake via a blueberry drink induced lowest increase and thus may be protective.
果糖摄入可能导致高尿酸血症,而高尿酸血症与肾脏疾病的风险增加和进展有关。我们旨在探索不同来源的果糖负荷,有无披萨,对慢性肾脏病(CKD)、无 CKD 的 2 型糖尿病(T2D)和健康受试者(HS)的血清尿酸水平的急性影响。
该研究纳入了 6 名 HS 和 3 名 CKD 4-5 期以及 7 名 T2D 患者。受试者饮用了蓝莓饮料(含 17.5g 果糖)、可口可乐(含 18g 果糖)和果糖饮料(含 35g 果糖)。这些饮料还与披萨一起饮用,共进行了 6 项干预。采集空腹和摄入后 30、60、90 和 120 分钟以及饮料+披萨摄入后 240 分钟的血清样本,分析果糖、尿酸和甘油三酯。使用重复测量方差分析探索餐后反应。
CKD 患者的血清尿酸基线水平升高(P=0.037)。所有组的饮料和饮料+披萨之间的血清果糖和血清尿酸水平在时间上均有显著差异(P<0.001 和 P<0.05)。血清果糖的最高峰值紧随果糖饮料干预,而蓝莓饮料的最低。果糖饮料干预引起的血清尿酸最高反应,而蓝莓饮料的最低反应。披萨干预后甘油三酯增加(P<0.001)。
果糖摄入会增加血清尿酸。通过蓝莓饮料摄入的果糖引起的尿酸增加最小,因此可能具有保护作用。