A rise in fructose consumption has been implicated in the etiology of obesity, diabetes and cardiovascular disease. Serum uric acid (UA) elevates after fructose ingestion, increasing the risk of cardiovascular disease. However, the impact of fructose ingestion on nitric oxide (NO) has not yet been confirmed. The aim of this study was to investigate the postprandial metabolic and endocrine responses following an acute ingestion of fructose and glucose in healthy subjects. This was a double-blinded, randomized, crossover postprandial trial. Eighteen healthy young subjects (9 males and 9 females) with a mean age of 23.6±2.3 years and mean BMI of 20.2±1.5kg/m2 completed the experiment that was conducted in Hangzhou, China. Volunteers were randomized to two groups (A and B): after an 8-h overnight fast, volunteers either ingested 300mL of 25% glucose (group A) or fructose (group B) solution at 0830 within 5min. After a one-week washout period, volunteers were crossed over to receive the alternate test solution. Blood pressure was measured at 0h, 1h, 2h and 3h and venous blood was drawn at 0h, 0.5h, 1h, 2h and 3h after ingestion of the test solution. Eighteen subjects completed the study. Serum NO level tended to be lower at 1h (59.40±3.10μmol/L and 68.1±3.40μmol/L, respectively, p≤0.05) and 2h (62.70±3.10μmol/L and 70.10±3.50μmol/L, respectively, p≤0.05) after fructose ingestion than after glucose. The 3-h AUC (area under curve) of NO was significantly lower after fructose ingestion than after glucose (p≤0.05). UA level was higher at 1h (512.17±17.74μmol/L and 372.11±17.41μmol/L, respectively, p≤0.01) and 2h (440.22±16.07μmol/L and 357.39±14.80μmol/L, respectively, p≤0.05) after fructose ingestion than after glucose. The 3-h AUC of UA was significantly higher after fructose ingestion than after glucose (p≤0.01). Correlation analyses revealed that NO was negatively associated with UA at T0.5h (r=-0.62, p≤0.01), T1.0h (r=-0.69, p≤0.001), T2.0h (r=-0.86, p≤0.001) and T3.0h (r=-0.85, p≤0.001) after fructose ingestion. SBP (systolic blood pressure) tended to be higher at 1h (125.33±1.95mmHg and 112.06±1.77mmHg, respectively, p≤0.05) after fructose ingestion than after glucose. The 3-h AUC of SBP was significantly higher after fructose ingestion than after glucose (p≤0.05). The 3h-AUC of TG, TC, HDL-C and LDL-C showed no differences between fructose and glucose. LDH (lactate dehydrogenase) level was higher at 1h (195.00±5.6U/L and 177.67±6.8U/L, respectively, p≤0.05) and 2h (197.01±6.32U/L and 185.50±7.37U/L, respectively, p≤0.05) after fructose ingestion than after glucose. The 3-h AUC of LDH was significantly higher after fructose ingestion than after glucose (p≤0.05). AR was significantly higher at 1h (19.86±0.52ng/mg Hb and 16.98±0.29ng/mg Hb, respectively, p≤0.05) after fructose ingestion than after glucose. The 3-h AUC of AR (p≤0.05) was significantly higher after fructose ingestion than after glucose (p≤0.05). Ingestion of a 75g fructose load led to acute but unfavorable changes in certain metabolic and endocrine responses including increased serum concentrations and 3h-AUC of UA, AR and LDH, increased SBP, and decreased endothelial NO production when compared with the same amount of ingested glucose.