Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children With Obesity.

Autor:	Schwarz JM; Touro University California College of Osteopathic Medicine, Vallejo, California; Department of Medicine, Division of Endocrinology, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California. Electronic address: Jean-Marc.Schwarz@tu.edu., Noworolski SM; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California., Erkin-Cakmak A; Department of Pediatrics, University of California, San Francisco, Benioff Children's Hospital, San Francisco, California., Korn NJ; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California., Wen MJ; Department of Medicine, Division of Endocrinology, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California., Tai VW; Clinical and Translational Science Institute Clinical Research Service, University of California, San Francisco, San Francisco, California., Jones GM; Touro University California College of Osteopathic Medicine, Vallejo, California., Palii SP; Touro University California College of Osteopathic Medicine, Vallejo, California., Velasco-Alin M; Touro University California College of Osteopathic Medicine, Vallejo, California; Department of Medicine, Division of Endocrinology, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California., Pan K; Department of Medicine, Division of Endocrinology, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California., Patterson BW; Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri., Gugliucci A; Touro University California College of Osteopathic Medicine, Vallejo, California., Lustig RH; Department of Pediatrics, University of California, San Francisco, Benioff Children's Hospital, San Francisco, California., Mulligan K; Touro University California College of Osteopathic Medicine, Vallejo, California; Department of Medicine, Division of Endocrinology, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California.
Jazyk:	angličtina
Zdroj:	Gastroenterology [Gastroenterology] 2017 Sep; Vol. 153 (3), pp. 743-752. Date of Electronic Publication: 2017 Jun 01.
DOI:	10.1053/j.gastro.2017.05.043
Abstrakt:	Background & Aims: Consumption of sugar is associated with obesity, type 2 diabetes mellitus, nonalcoholic fatty liver disease, and cardiovascular disease. The conversion of fructose to fat in liver (de novo lipogenesis [DNL]) may be a modifiable pathogenetic pathway. We determined the effect of 9 days of isocaloric fructose restriction on DNL, liver fat, visceral fat (VAT), subcutaneous fat, and insulin kinetics in obese Latino and African American children with habitual high sugar consumption (fructose intake >50 g/d). Methods: Children (9-18 years old; n = 41) had all meals provided for 9 days with the same energy and macronutrient composition as their standard diet, but with starch substituted for sugar, yielding a final fructose content of 4% of total kilocalories. Metabolic assessments were performed before and after fructose restriction. Liver fat, VAT, and subcutaneous fat were determined by magnetic resonance spectroscopy and imaging. The fractional DNL area under the curve value was measured using stable isotope tracers and gas chromatography/mass spectrometry. Insulin kinetics were calculated from oral glucose tolerance tests. Paired analyses compared change from day 0 to day 10 within each child. Results: Compared with baseline, on day 10, liver fat decreased from a median of 7.2% (interquartile range [IQR], 2.5%-14.8%) to 3.8% (IQR, 1.7%-15.5%) (P < .001) and VAT decreased from 123 cm 3 (IQR, 85-145 cm 3 ) to 110 cm 3 (IQR, 84-134 cm 3 ) (P < .001). The DNL area under the curve decreased from 68% (IQR, 46%-83%) to 26% (IQR, 16%-37%) (P < .001). Insulin kinetics improved (P < .001). These changes occurred irrespective of baseline liver fat. Conclusions: Short-term (9 days) isocaloric fructose restriction decreased liver fat, VAT, and DNL, and improved insulin kinetics in children with obesity. These findings support efforts to reduce sugar consumption. ClinicalTrials.gov Number: NCT01200043. (Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu