Fructose: A New Variable to Consider in SIADH and the Hyponatremia Associated With Long-Distance Running?
Fructose: A New Variable to Consider in SIADH and the Hyponatremia Associated With Long-Distance Running?
复制标题
DOI：
10.1053/j.ajkd.2023.01.443
复制
发表时间：
2023-06-21
影响因子：
13.2
通讯作者：
Maesaka，John
中科院分区：
文献类型：
--
作者：
Johnson，Richard J.;Lee，S. M. Kurt;Maesaka，John
果糖最近被提出用来刺激人类的加压素分泌。果糖诱导的加压素分泌不仅被认为是摄入含有果糖的饮料的结果，也可能是通过激活多元醇途径产生内源性果糖。这就提出了一个问题，即果糖是否可能参与了一些后叶加压素诱导的低钠血症，特别是在原因尚不完全清楚的情况下，例如利尿剂激素分泌不当(SIADH)综合征和运动性低钠血症，这在马拉松跑步者中已经观察到。在这里，我们讨论果糖和加压素的新科学，以及它如何在这些疾病中的一些情况下发挥作用，以及在与快速治疗相关的并发症(如渗透性脱髓鞘综合征)中发挥作用。测试果糖作用的研究可以为这些常见疾病提供新的病理生理学见解和新的潜在治疗策略。
Fructose has recently been proposed to stimulate vasopressin secretion in humans. Fructose-induced vasopressin secretion is not only postulated to result from ingestion of fructose-containing drinks but may also occur from endogenous fructose production via activation of the polyol pathway. This raises the question of whether fructose might be involved in some cases of vasopressin-induced hyponatremia, especially in situations where the cause is not fully known such as in the syndrome of inappropriate secretion of diuretic hormone (SIADH) and exercise-associated hyponatremia, which has been observed in marathon runners. Here we discuss the new science of fructose and vasopressin, and how it may play a role in some of these conditions, as well as in the complications associated with rapid treatment (such as the osmotic demyelination syndrome). Studies to test the role of fructose could provide new pathophysiologic insights as well as novel potential treatment strategies for these common conditions.