A Dual Sugar Challenge Test for Lipogenic Sensitivity to Dietary Fructose
A Dual Sugar Challenge Test for Lipogenic Sensitivity to Dietary Fructose
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DOI：
10.1210/jc.2010-2007
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发表时间：
2011-03-01
影响因子：
5.8
通讯作者：
Hellerstein, Marc K.
中科院分区：
文献类型：
--
作者：
Hudgins, Lisa C.;Parker, Thomas S.;Hellerstein, Marc K.
内容：增加肝脏新生脂肪生成（DNL）在饮食糖的反应是牵连在血脂异常，脂肪肝，和insulinresistance.Objective：该研究的目的是开发一个简单的门诊耐受性测试脂肪敏感性饮食糖。设计和设置：在反复服用果糖的住院病人中，方案1比较了由极低密度脂蛋白甘油三酯（TG）中棕榈酸酯（“新棕榈酸酯”）的百分比和同位素标记的棕榈酸酯（“% DNL”）的百分比测定的DNL的急性增加。方案2采用随机交叉设计，比较了门诊患者饮用三种不同的含糖饮料后新棕榈酸酯的增加情况。参与者：方案1中有15名消瘦和超重的志愿者，方案2中有15名超重的志愿者。在方案2中，受试者分别接受0.5g/kg果糖、0.5g/kg果糖加0.5g/kg葡萄糖或1g/kg果糖加1g/kg葡萄糖作为单次口服推注。结果如下：在重复剂量的果糖后，新的棕榈酸酯与%DNL的增加显著相关（Delta，r = 0.814; P < 0.001），与空腹胰岛素水平显著相关（曲线下面积，r = 0.754; P = 0.001）。在单一糖剂量后，新棕榈酸酯显示出剂量效应，并且在果糖加葡萄糖后更大。非常低密度脂蛋白TG和总TG显着增加，在这两个protocols.Conclusions：一个单一的口服团的果糖和葡萄糖迅速增加血清TG和TG棕榈酸在超重的受试者。双重糖挑战试验可以证明是有用的，以确定个人的风险，碳水化合物引起的血脂异常和其他不利影响增加DNL。（临床内分泌代谢杂志96：861-868，2011）
Context: Increased hepatic de novo lipogenesis (DNL) in response to dietary sugar is implicated in dyslipidemia, fatty liver, and insulin resistance.Objective: The aim of the study was to develop a simple outpatient tolerance test for lipogenic sensitivity to dietary sugar.Design and Setting: In inpatients given repeated doses of fructose, protocol 1 compared the acute increase in DNL determined from the percentage of palmitate ("new palmitate") and the percentage of isotopically labeled palmitate ("% DNL")in very low-density lipoprotein triglyceride (TG). Protocol 2 compared the increase in new palmitate in outpatients given three different sugar beverages in a randomized crossover design.Participants: There were 15 lean and overweight volunteers in protocol 1 and 15 overweight volunteers in protocol 2.Interventions: In protocol 1, subjects received 1.4 g/kg fructose in divided oral doses over 6 h; in protocol 2, subjects received 0.5 g/kg fructose, 0.5 g/kg fructose plus 0.5g/kg glucose, or 1 g/kg fructose plus 1g/kg glucose each as a single oral bolus.Main Outcome Measures: We measured the increase in DNL by two methods. Results: After repeated doses of fructose, new palmitate was significantly correlated with the increase in %DNL (Delta, r = 0.814; P < 0.001) and with fasting insulin levels (area under the curve, r = 0.754; P = 0.001). After a single sugar dose, new palmitate showed a dose effect and was greater after fructose plus glucose. Very low-density lipoprotein TG and total TG significantly increased in both protocols.Conclusions: A single oral bolus of fructose and glucose rapidly increases serum TG and TG palmitate in overweight subjects. A dual sugar challenge test could prove useful to identify individuals at risk for carbohydrate-induced dyslipidemia and other adverse effects of increased DNL. (J Clin Endocrinol Metab 96: 861-868, 2011)