Document Detail


Effects of fructose vs glucose on regional cerebral blood flow in brain regions involved with appetite and reward pathways.
MedLine Citation:
PMID:  23280226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
IMPORTANCE: Increases in fructose consumption have paralleled the increasing prevalence of obesity, and high-fructose diets are thought to promote weight gain and insulin resistance. Fructose ingestion produces smaller increases in circulating satiety hormones compared with glucose ingestion, and central administration of fructose provokes feeding in rodents, whereas centrally administered glucose promotes satiety.
OBJECTIVE: To study neurophysiological factors that might underlie associations between fructose consumption and weight gain.
DESIGN, SETTING, AND PARTICIPANTS: Twenty healthy adult volunteers underwent 2 magnetic resonance imaging sessions at Yale University in conjunction with fructose or glucose drink ingestion in a blinded, random-order, crossover design.
MAIN OUTCOME MEASURES: Relative changes in hypothalamic regional cerebral blood flow (CBF) after glucose or fructose ingestion. Secondary outcomes included whole-brain analyses to explore regional CBF changes, functional connectivity analysis to investigate correlations between the hypothalamus and other brain region responses, and hormone responses to fructose and glucose ingestion.
RESULTS: There was a significantly greater reduction in hypothalamic CBF after glucose vs fructose ingestion (-5.45 vs 2.84 mL/g per minute, respectively; mean difference, 8.3 mL/g per minute [95% CI of mean difference, 1.87-14.70]; P = .01). Glucose ingestion (compared with baseline) increased functional connectivity between the hypothalamus and the thalamus and striatum. Fructose increased connectivity between the hypothalamus and thalamus but not the striatum. Regional CBF within the hypothalamus, thalamus, insula, anterior cingulate, and striatum (appetite and reward regions) was reduced after glucose ingestion compared with baseline (P < .05 significance threshold, family-wise error [FWE] whole-brain corrected). In contrast, fructose reduced regional CBF in the thalamus, hippocampus, posterior cingulate cortex, fusiform, and visual cortex (P < .05 significance threshold, FWE whole-brain corrected). In whole-brain voxel-level analyses, there were no significant differences between direct comparisons of fructose vs glucose sessions following correction for multiple comparisons. Fructose vs glucose ingestion resulted in lower peak levels of serum glucose (mean difference, 41.0 mg/dL [95% CI, 27.7-54.5]; P < .001), insulin (mean difference, 49.6 μU/mL [95% CI, 38.2-61.1]; P < .001), and glucagon-like polypeptide 1 (mean difference, 2.1 pmol/L [95% CI, 0.9-3.2]; P = .01).
CONCLUSION AND RELEVANCE: In a series of exploratory analyses, consumption of fructose compared with glucose resulted in a distinct pattern of regional CBF and a smaller increase in systemic glucose, insulin, and glucagon-like polypeptide 1 levels.
Authors:
Kathleen A Page; Owen Chan; Jagriti Arora; Renata Belfort-Deaguiar; James Dzuira; Brian Roehmholdt; Gary W Cline; Sarita Naik; Rajita Sinha; R Todd Constable; Robert S Sherwin
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  309     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-02     Completed Date:  2013-01-03     Revised Date:  2014-03-25    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  63-70     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Appetite / drug effects,  physiology
Beverages
Blood-Brain Barrier
Brain / blood supply*,  drug effects*
Cross-Over Studies
Female
Fructose / administration & dosage,  pharmacokinetics,  pharmacology*
Glucagon-Like Peptide 1 / drug effects,  metabolism
Glucose / administration & dosage,  metabolism,  pharmacology*
Humans
Hunger / drug effects,  physiology
Hypothalamus / blood supply,  drug effects
Insulin / metabolism
Magnetic Resonance Imaging
Male
Rats
Regional Blood Flow / drug effects*
Reward
Single-Blind Method
Grant Support
ID/Acronym/Agency:
DK 20495/DK/NIDDK NIH HHS; P30 DK 45735/DK/NIDDK NIH HHS; R01 DK020495/DK/NIDDK NIH HHS; T32 DK007058/DK/NIDDK NIH HHS; T32 DK07058/DK/NIDDK NIH HHS; UL1 RR024139/RR/NCRR NIH HHS; UL1 RR024139/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Insulin; 30237-26-4/Fructose; 89750-14-1/Glucagon-Like Peptide 1; IY9XDZ35W2/Glucose
Comments/Corrections
Comment In:
JAMA. 2013 Jan 2;309(1):85-6   [PMID:  23280229 ]
JAMA. 2013 May 1;309(17):1768   [PMID:  23632709 ]
JAMA. 2013 May 1;309(17):1769   [PMID:  23632711 ]
JAMA. 2013 May 1;309(17):1768-9   [PMID:  23632710 ]
Erratum In:
JAMA. 2013 May 1;309(17):1773

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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