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Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric acid in the hypertensive response

International Journal of Obesity volume 34, pages 454–461 (2010)Cite this article

Abstract

Background:

Excessive fructose intake causes metabolic syndrome in animals and can be partially prevented by lowering the uric acid level. We tested the hypothesis that fructose might induce features of metabolic syndrome in adult men and whether this is protected by allopurinol.

Methods:

A randomized, controlled trial of 74 adult men who were administered 200 g fructose daily for 2 weeks with or without allopurinol. Primary measures included changes in ambulatory blood pressure (BP), fasting lipids, glucose and insulin, homeostatic model assessment (HOMA) index, body mass index and criteria for metabolic syndrome.

Results:

The ingestion of fructose resulted in an increase in ambulatory BP (7±2 and 5±2 mm Hg for systolic (SBP) and diastolic BP (DBP), P<0.004 and P<0.007, respectively). Mean fasting triglycerides increased by 0.62±0.23 mmol l−1 (55±20 mg per 100 ml), whereas high-density lipoprotein cholesterol decreased by 0.06±0.02 mmol l−1 (2.5±0.7 mg per 100 ml), P<0.002 and P<0.001, respectively. Fasting insulin and HOMA indices increased significantly, whereas plasma glucose level did not change. All liver function tests showed an increase in values. The metabolic syndrome increased by 25–33% depending on the criteria. Allopurinol lowered the serum uric acid level (P<0.0001) and prevented the increase in 24-h ambulatory DBP and daytime SBP and DBP. Allopurinol treatment did not reduce HOMA or fasting plasma triglyceride levels, but lowered low-density lipoprotein cholesterol relative to control (P<0.02) and also prevented the increase in newly diagnosed metabolic syndrome (0–2%, P=0.009).

Conclusions:

High doses of fructose raise the BP and cause the features of metabolic syndrome. Lowering the uric acid level prevents the increase in mean arterial blood pressure. Excessive intake of fructose may have a role in the current epidemics of obesity and diabetes.

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Acknowledgements

We thank the volunteers and staff who participated in the study. Dr Enrique Perez-Pozo had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Trial registration: clinicaltrials.gov identifier number: NCT00639756. Support for this publication was provided by generous funds from the Mateo Orfila Foundation.

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Authors and Affiliations

  1. Renal Unit, Son Llatzer Hospital—Palm of Majorca, Balearic Islands, Spain

    S E Perez-Pozo

  2. Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL, USA

    J Schold, T Nakagawa, L G Sánchez-Lozada & R J Johnson

  3. Renal Unit, Mateo Orfila Hospital—Minorca, Balearic Islands, Spain

    S E Perez-Pozo & J López Lillo

  4. Division of Renal Diseases and Hypertension, University of Colorado, Denver, CO, USA

    T Nakagawa, L G Sánchez-Lozada & R J Johnson

Authors
  1. S E Perez-Pozo
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  2. J Schold
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  3. T Nakagawa
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  4. L G Sánchez-Lozada
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  5. R J Johnson
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  6. J López Lillo
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Correspondence to S E Perez-Pozo.

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Perez-Pozo, S., Schold, J., Nakagawa, T. et al. Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric acid in the hypertensive response. Int J Obes 34, 454–461 (2010). https://doi.org/10.1038/ijo.2009.259

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  • DOI: https://doi.org/10.1038/ijo.2009.259

Keywords

  • fructose
  • high-fructose corn syrup
  • sucrose
  • metabolic syndrome
  • uric acid
  • allopurinol

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