NDLI: A dual sugar challenge test for lipogenic sensitivity to dietary fructose.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hellerstein, Marc K. Levine, Daniel M. Hudgins, Lisa C. Parker, Thomas S.
Description	Country affiliation: United States Author Affiliation: Hudgins LC ( The Rogosin Institute, New York, New York 10065, USA. lih2013@nyp.org)
Abstract	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 0.5 g/kg glucose, or 1 g/kg fructose plus 1 g/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 (Δ, 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.
ISSN	0021972X
e-ISSN	19457197
DOI	10.1210/jc.2010-2007
Journal	The Journal of Clinical Endocrinology & Metabolism
Issue Number	3
Volume Number	96
Language	English
Publisher	Oxford University Press
Publisher Date	2011-03-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Dietary Carbohydrates Pharmacology Fructose Lipid Metabolism Drug Effects Adipose Tissue Anatomy & Histology Blood Glucose Metabolism Cross-over Studies Diet Fatty Acids Glucose Isotope Labeling Lipoproteins, Vldl Blood Liver Palmitates Triglycerides Randomized Controlled Trial Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Discipline Endocrinology Discipline Metabolism
Content Type	Text
Resource Type	Article
Subject	Biochemistry (medical) Endocrinology, Diabetes and Metabolism Clinical Biochemistry Biochemistry Endocrinology

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