Effect of fructose consumption on insulin sensitivity in nondiabetic subjects: a systematic review and meta-analysis of diet-intervention trials

Abstract

Short-term fructose consumption, in isocaloric exchange or in hypercaloric supplementation, promotes the development of hepatic insulin resistance in nondiabetic adults without affecting peripheral or muscle insulin sensitivity. Larger and longer-term studies are needed to assess whether real-world fructose consumption has adverse effects on insulin sensitivity and long-term outcomes.

Fructose metabolism and metabolic disease

“…This ChREBP/G6PC signaling axis is also conserved in humans. These results are consistent with dietary intervention studies in humans indicating that either eucaloric substitution or hypercaloric addition of fructose may have more significant effects on hepatic insulin resistance than peripheral insulin resistance (157). However, as hyperinsulinemia itself can induce peripheral insulin resistance (162,163), we speculate that chronic hyperinsulinemia that compensates for fructose-induced glucose production may subsequently lead to peripheral insulin resistance.…”

“…Moreover, hyperinsulinemia is more pronounced in rodent models with high-fructose compared with high-dextrose feeding despite similar increases in body weight and adiposity (155,156). Similarly, hypercaloric fructose feeding increases circulating insulin in human subjects (157). Fructose-induced hyperinsulinemia, often considered a proxy for insulin resistance, might be the result of insulin resistance in some combination of liver, muscle, and/or adipose tissue.…”

Childhood Fructoholism and Fructoholic Liver Disease

“…One of those effects is intrahepatic lipid accumulation (steatosis) due to an increase in hepatic fatty acid (FA) synthesis from de novo lipogenesis (DNL), an increase in hepatic delivery of FAs, and a decrease in lipid clearance . Dietary sugars have been shown to enhance hepatic DNL, a metabolic pathway that affects lipid and glucose regulation and induces insulin resistance, cardiovascular disease, and hepatic steatosis . Hepatic fructose metabolism results in available substrate to DNL and enhancement of regulatory signals to promote hepatic lipid synthesis, leading to serum triglycerides rising after acute fructose ingestion .…”

Metabolic effects of excessive consumption of fructose

“…w metaanalizie 29 badań wykazali, że krótkotrwałe (< 60 dni) izokaloryczne zastąpienie węglowodanów fruktozą lub hiperkaloryczna suplementacja sprzyjają rozwojowi insulinooporności w wątrobie u osób dorosłych bez cukrzycy i pozostają bez wpływu na wrażli-wość na insulinę obwodową lub mięśni [40].…”