Acute lipids response to fructose beverage in adolescents with NAFLD

Abstract

ObjectiveDyslipidemia and insulin resistance are commonly reported in nonalcoholic fatty liver disease (NAFLD). In this study, we investigated the acute lipid response to fructose in adolescents with NAFLD (hepatic fat >; 5% by MRS), and examined the difference as compared to similar overweight adolescents with normal hepatic fat (< 5%, non‐NAFLD).MethodsWe recruited overweight Hispanic adolescents that self‐reported high consumption of sugar beverages (≥24 oz per day) as this is known to be a high risk population for NAFLD. 50 recruited subjects underwent a fructose tolerance test, and their blood samples were collected at fasting and 30, 60, 90 min after oral fructose load (50 grams).ResultsOver 70% of study population had NAFLD, and they had higher ALT (p=0.003), AST (p<0.001), fasting TG (p=0.003), insulin (p=0.005), HOMA‐IR (p=0.01), and adipose IR (p<0.001), as compared to non‐NAFLD. With fructose load, plasma glucose response was not different between the two groups; however, NAFLD subjects had high AUC of insulin (40.6 ± 6.1 vs. 17.2 ± 3.1, p=0.001) and less FFA suppress (AUC: 0.19 ± 0.07 vs. 0.46 ± 0.09, p=0.05).ConclusionOverweight Hispanic adolescents with increased hepatic steatosis are more insulin resistant compared to similar non‐NAFLD overweight adolescents. This insulin resistance results in decreased tolerance of an oral fructose bolus as demonstrated by failure of NEFA suppression.