Publication: Carbohydrate intake and nonalcoholic fatty liver disease: fructose as a weapon of mass destruction
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Date
2015-04-01
Authors
Basaranoglu, METİN
Basaranoglu, GÖKÇEN
Bugianesi, Elisabetta
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Abstract
Excessive accumulation of triglycerides (TG) in liver, in the absence of significant alcohol
consumption is nonalcoholic fatty liver disease (NAFLD). NAFLD is a significant risk factor for developing
cirrhosis and an independent predictor of cardiovascular disease. High fructose corn syrup (HFCS)-containing
beverages were associated with metabolic abnormalities, and contributed to the development of NAFLD in
human trials. Ingested carbohydrates are a major stimulus for hepatic de novo lipogenesis (DNL) and are
more likely to directly contribute to NAFLD than dietary fat. Substrates used for the synthesis of newly
made fatty acids by DNL are primarily glucose, fructose, and amino acids. Epidemiological studies linked
HFCS consumption to the severity of fibrosis in patients with NAFLD. New animal studies provided
additional evidence on the role of carbohydrate-induced DNL and the gut microbiome in NAFLD. The
excessive consumption of HFCS-55 increased endoplasmic reticulum stress, activated the stress-related
kinase, caused mitochondrial dysfunction, and increased apoptotic activity in the liver. A link between dietary
fructose intake, increased hepatic glucose transporter type-5 (Glut5) (fructose transporter) gene expression
and hepatic lipid peroxidation, MyD88, TNF-α levels, gut-derived endotoxemia, toll-like receptor-4, and
NAFLD was reported. The lipogenic and proinflammatory effects of fructose appear to be due to transient
ATP depletion by its rapid phosphorylation within the cell and from its ability to raise intracellular and
serum uric acid levels. However, large prospective studies that evaluated the relationship between fructose
and NAFLD were not performed yet
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Basaranoglu M., Basaranoglu G., Bugianesi E., -Carbohydrate intake and nonalcoholic fatty liver disease: fructose as a weapon of mass destruction-, HEPATOBILIARY SURGERY AND NUTRITION, cilt.4, ss.109-116, 2015