Journal Article

Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric acid in the hypertensive response

Sánchez-Lozada, L.G, Schold, J, López Lillo, J, Nakagawa, T, Perez-Pozo, S.E, Johnson, R.J

2010

Overview

Background: Excessive fructose intake causes metabolic syndrome in animals and can be partially prevented by lowering the uric acid level. We tested the hypothesis that fructose might induce features of metabolic syndrome in adult men and whether this is protected by allopurinol. Methods: A randomized, controlled trial of 74 adult men who were administered 200 g fructose daily for 2 weeks with or without allopurinol. Primary measures included changes in ambulatory blood pressure (BP), fasting lipids, glucose and insulin, homeostatic model assessment (HOMA) index, body mass index and criteria for metabolic syndrome. Results: The ingestion of fructose resulted in an increase in ambulatory BP (7±2 and 5±2 mm Hg for systolic (SBP) and diastolic BP (DBP), P<0.004 and P<0.007, respectively). Mean fasting triglycerides increased by 0.62±0.23 mmol l−1 (55±20 mg per 100 ml), whereas high-density lipoprotein cholesterol decreased by 0.06±0.02 mmol l−1 (2.5±0.7 mg per 100 ml), P<0.002 and P<0.001, respectively. Fasting insulin and HOMA indices increased significantly, whereas plasma glucose level did not change. All liver function tests showed an increase in values. The metabolic syndrome increased by 25–33% depending on the criteria. Allopurinol lowered the serum uric acid level (P<0.0001) and prevented the increase in 24-h ambulatory DBP and daytime SBP and DBP. Allopurinol treatment did not reduce HOMA or fasting plasma triglyceride levels, but lowered low-density lipoprotein cholesterol relative to control (P<0.02) and also prevented the increase in newly diagnosed metabolic syndrome (0–2%, P=0.009). Conclusions: High doses of fructose raise the BP and cause the features of metabolic syndrome. Lowering the uric acid level prevents the increase in mean arterial blood pressure. Excessive intake of fructose may have a role in the current epidemics of obesity and diabetes.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: administration & dosage / Adult / adverse effects / Aged / allopurinol / Allopurinol - therapeutic use / Antimetabolites / Antimetabolites - therapeutic use / Arterial hypertension. Arterial hypotension / Biological and medical sciences / blood / Blood and lymphatic vessels / blood glucose / Blood Glucose - metabolism / blood lipids / Blood pressure / Blood Pressure - drug effects / Blood Pressure Monitoring, Ambulatory / Body Mass Index / Cardiology. Vascular system / chemically induced / Cholesterol / Corn syrup / Development and progression / Diabetes / diet / drug effects / drug therapy / Epidemics / Epidemiology / Fasting / Fasting - blood / Fructose / Fructose - administration & dosage / Fructose - adverse effects / Fructose - blood / Glucose / Health aspects / Health Promotion and Disease Prevention / High density lipoprotein / human diseases / human nutrition / Humans / Hypertension / Hypertension - blood / Hypertension - drug therapy / Hypotheses / Ingestion / Insulin / Insulin - blood / Insulin resistance / Internal Medicine / Lipids / Lipids - blood / Lipoproteins / Male / Medical sciences / Medicine / Medicine & Public Health / men / Metabolic Diseases / Metabolic disorders / Metabolic syndrome / Metabolic Syndrome - blood / Metabolic Syndrome - chemically induced / Metabolic Syndrome - prevention & control / Metabolic syndrome X / metabolism / Middle Aged / Miscellaneous / Obesity / obesity-related diseases / original-article / Other metabolic disorders / Pilot Projects / Plasma / Prevention / prevention & control / Public Health / Purines and pyrimidines (gout, hyperuricemia...) / randomized clinical trials / Risk factors / therapeutic use / triacylglycerols / Triglycerides / Triglycerides - blood / Uric acid / Uric Acid - blood