Purpose of Review

The objective of this review is to provide up-to-date and comprehensive discussion of tissue-specific fructose metabolism in the context of diabetes, dyslipidemia, and nonalcoholic fatty liver disease (NAFLD).

Recent Findings

Increased intake of dietary fructose is a risk factor for a myriad of metabolic complications. Tissue-specific fructose metabolism has not been well delineated in terms of its contribution to detrimental health effects associated with fructose intake. Since inhibitors targeting fructose metabolism are being developed for the management of NAFLD and diabetes, it is essential to recognize how inability of one tissue to metabolize fructose may affect metabolism in the other tissues. The primary sites of fructose metabolism are the liver, intestine, and kidney. Skeletal muscle and adipose tissue can also metabolize a large portion of fructose load, especially in the setting of ketohexokinase deficiency, the rate-limiting enzyme of fructose metabolism. Fructose can also be sensed by the pancreas and the brain, where it can influence essential functions involved in energy homeostasis. Lastly, fructose is metabolized by the testes, red blood cells, and lens of the eye where it may contribute to infertility, advanced glycation end products, and cataracts, respectively.

Summary

An increase in sugar intake, particularly fructose, has been associated with the development of obesity and its complications. Inhibition of fructose utilization in tissues primary responsible for its metabolism alters consumption in other tissues, which have not been traditionally regarded as important depots of fructose metabolism.

中文翻译：

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肥胖和糖尿病的组织特异性果糖代谢

审查目的

本综述的目的是对糖尿病、血脂异常和非酒精性脂肪性肝病 (NAFLD) 背景下的组织特异性果糖代谢进行最新和全面的讨论。

最近的发现

饮食中果糖摄入量的增加是导致无数代谢并发症的危险因素。就其对与果糖摄入相关的有害健康影响的贡献而言，组织特异性果糖代谢尚未得到很好的描述。由于正在开发针对果糖代谢的抑制剂来治疗 NAFLD 和糖尿病，因此必须认识到一种组织不能代谢果糖可能会如何影响其他组织的代谢。果糖代谢的主要部位是肝脏、肠道和肾脏。骨骼肌和脂肪组织也可以代谢大部分果糖负荷，尤其是在酮糖激酶缺乏的情况下，酮糖激酶是果糖代谢的限速酶。果糖也可以被胰腺和大脑感知，它可以影响能量稳态中涉及的基本功能。最后，果糖被睾丸、红细胞和眼睛晶状体代谢，可能分别导致不育、晚期糖基化终产物和白内障。

概括

糖摄入量的增加，尤其是果糖摄入量的增加与肥胖及其并发症的发生有关。抑制主要负责其代谢的组织中的果糖利用会改变其他组织的消耗，这些组织传统上不被视为果糖代谢的重要仓库。