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Cellular energy may be depleted in patients with obesity anddiabetes by increased fructose consumpt by dedwf wefweg





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Cellular energy may be depleted in patients with obesity anddiabetes by increased fructose consumpt by
Article Posted: 05/31/2013
Article Views: 100
Articles Written: 1942
Word Count: 608
Article Votes: 0
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Cellular energy may be depleted in patients with obesity anddiabetes by increased fructose consumpt


 
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Obese people who consume increased amounts of fructose, a type ofsugar that is found in particular in soft drinks and fruit juices,are at risk for nonalcoholic fatty liver disease (NFALD) and moreits more severe forms, fatty inflammation and scarring. Now researchers at Duke University Medical Center believe theybetter understand what mechanism may account for fructose-relatedliver injury. Chronic fructose consumption in a diet puts people at risk fordepleting their store of critically important molecules called ATP,which provide liver cells (and other body cells) energy forimportant cellular processes, including metabolism. "The stores of liver ATP are decreased in obese and/or diabeticindividuals who chronically consume increased amounts offructose-containing beverages," said lead author Manal Abdelmalek,M.D., MPH, Associate Professor of Gastroenterology & Hepatology atDuke. The study was published online at the Hepatology journal site.

Nonalcoholic fatty liver disease is currently the leading cause ofchronic liver disease in the United States. This condition can leadto elevated liver enzymes, inflammation and rarely even advancedscarring ( cirrhosis ) in individuals who do not drink alcohol. In obesity and/or diabetes , the ability of the cells to optimally make ATP may already beimpaired. Unlike other simple sugars, fructose requires ATP for itsmetabolism.

The inability to optimally generate cellular energy aswell and the continued consumption of ATP from chronic fructoseingestion can result in the liver's depletion of energy. ATPdepletion may increase risk for inflammation and scarring in theliver. "The state of being insulin resistant impairs the ability of avital enzyme, AMP kinase, to make new ATP molecules," Abdelmalekexplained. "Increased fructose consumption, and excess utilizationof ATP favors the increase in molecules that lead to increasedfatty acid synthesis as well as increased uric acid." The researchers also noted that more uric acid is produced in thebody when excess fructose is consumed. Too much uric acid isassociated with conditions that include gout , high blood pressure , cardiovascular disease, type 2 diabetes, metabolic syndrome anduric acid stones, a form of kidney stones.

The silver lining is that measuring the amount of uric acid inthese individuals may help doctors predict the presence and monitorthe severity of nonalcoholic fatty liver disease, Abdelmalek said. Research Abdelmalek published in the Journal of Hepatology in 2008 showed that, within a small subset of patients,fructose-containing beverages were associated with NAFLD comparedto patients with comparable weight, age, and gender. Her 2010research, published in Hepatology, went further and linked fructosewith the liver injury and scarring (fibrosis). The current study evaluated adults enrolled in the NIH-sponsoredLook Ahead Fatty Liver Disease Ancillary Study headed by seniorauthor Jeanne M.Clark, M.D., MPH, at Johns Hopkins University.

Theresearchers analyzed dietary questionnaires collected in patientswho underwent a magnetic resonance imaging to measure liver fat aswell as an intravenous fructose challenge to evaluate the liver'sATP stores and response to ATP depletion. Patients enrolled in the Look Ahead study had been counseled onlower dietary sugar consumption for the management of diabetes.Despite the overall lower levels of fructose use in this studypopulation, the researchers found evidence of liver ATP depletionin those who consumed more fructose. "The fact we found a difference in liver ATP stores at lower levelsof dietary fructose intake does suggest that higher fructoseconsumption (as would occur with the consumption of processed foodand sweetened beverages) could deplete the liver of energy and thusrisk causing worse metabolic problems and potentially even liverinjury," Abdelmalek said. In the past 30 years, Abdelmalek andauthors wrote, fructose consumption has more than doubled.

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