Differences in acute metabolism of fructose between hemodialysis patients and healthy subjects
Differences in acute metabolism of fructose between hemodialysis patients and healthy subjects
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DOI：
10.3109/00365513.2012.758386
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发表时间：
2013-03-01
影响因子：
2.1
通讯作者：
Stenvinkel, Peter
中科院分区：
文献类型：
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作者：
Anderstam, Bjorn;Bragfors-Helin, Ann-Christin;Stenvinkel, Peter
在过去的几十年里，果糖的消费量急剧增加，并与肥胖、代谢综合征、糖尿病和慢性肾脏疾病（CKD）的流行相平行。自然界中，E。G.水果和蜂蜜（富含这种单糖）和蔗糖（食糖）。果糖的作用归因于其代谢过程中血清尿酸水平的短暂升高。最近的研究，也在CKD患者中，已经将果糖与脂质，葡萄糖和氧化自由基的代谢障碍联系起来。然而，对果糖的潜在有害影响缺乏普遍共识。我们改进了一种灵敏的菊糖测定法，用于测定血清和血浆中的果糖，并在对照组食用纯果糖后的急性实验中测试了其准确性。此外，果糖和尿酸进行了分析餐后240分钟内在6个维持性血液透析（HD）患者和9个健康受试者消耗190毫升奶油/75克蔗糖在空腹状态。而果糖水平在对照组中在60分钟后达到最大水平，而在HD患者中甚至在240分钟时还没有开始下降。同样，虽然对照组的尿酸水平保持稳定，但在餐后240分钟，HD患者的尿酸水平增加了10%。总之，富含葡萄糖和脂肪的膳食与HD患者果糖吸收和/或代谢延迟以及血清尿酸水平升高相关。
The consumption of fructose has increased dramatically during the last few decades and parallels the epidemics of obesity, metabolic syndrome, diabetes and chronic kidney disease (CKD). Fructose occurs naturally e. g. in fruit and in honey (rich in this monosaccharide) and as sucrose (table sugar). The effects of fructose have been attributed to the transient increases in serum uric acid levels during its metabolism. Recent research, also in CKD patients, has linked fructose to dysmetabolism of lipids, glucose and oxidative radicals. However, a general consensus of the potentially harmful effects of fructose is lacking. We improved a sensitive inulin assay for fructose measurement in serum and plasma and tested its accuracy in an acute experiment following consumption of pure fructose in controls. In addition, fructose and uric acid were analyzed postprandially during 240 min in six maintenance hemodialysis (HD) patients and nine healthy subjects consuming 190 ml cream/75 g sucrose in a fasting state. Whereas the fructose levels reached a maximum level after 60 min in controls they had not even started to decrease at 240 min in HD-patients. Likewise, while uric acid levels remained stable in controls they increased by 10% in HD patients at 240 min following the meal. In conclusion, a glucose and fat rich meal is associated with delayed absorption and/or metabolism of fructose in HD patients as well as increased serum uric acid levels.