Amée M Buziau1,2,3, Simone J P M Eussen2,4,5, M Eline Kooi2,6, Carla J H van der Kallen2,7, Martien C J M van Dongen4,5, Nicolaas C Schaper1,2,5, Ronald M A Henry2,7,8, Miranda T Schram2,7,8, Pieter C Dagnelie2,7, Marleen M J van Greevenbroek2,3, Anke Wesselius9,10, Otto Bekers2,11, Steven J R Meex2,11, Casper G Schalkwijk2,3, Coen D A Stehouwer2,7, Martijn C G J Brouwers1,2. 1. Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 2. School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands. 3. Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 4. Department of Epidemiology, Maastricht University, Maastricht, the Netherlands. 5. Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. 6. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 7. Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 8. Heart & Vascular Centre, Maastricht University Medical Center+, Maastricht, the Netherlands. 9. School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands. 10. Department of Complex Genetics and Epidemiology, Maastricht University, Maastricht, the Netherlands. 11. Central Diagnostic Laboratory, Department of Clinical Chemistry, Maastricht University Medical Center+, Maastricht, the Netherlands.
Abstract
OBJECTIVE: Epidemiological evidence regarding the relationship between fructose intake and intrahepatic lipid (IHL) content is inconclusive. We, therefore, assessed the relationship between different sources of fructose and IHL at the population level. RESEARCH DESIGN AND METHODS: We used cross-sectional data from The Maastricht Study, a population-based cohort study (n = 3,981; mean ± SD age: 60 ± 9 years; 50% women). We assessed the relationship between fructose intake (assessed with a food-frequency questionnaire)-total and derived from fruit, fruit juice, and sugar-sweetened beverages (SSB)-and IHL (quantified with 3T Dixon MRI) with adjustment for age, sex, type 2 diabetes, education, smoking status, physical activity, and intakes of total energy, alcohol, saturated fat, protein, vitamin E, and dietary fiber. RESULTS: Energy-adjusted total fructose intake and energy-adjusted fructose from fruit were not associated with IHL in the fully adjusted models (P = 0.647 and P = 0.767). In contrast, energy-adjusted intake of fructose from fruit juice and SSB was associated with higher IHL in the fully adjusted models (P = 0.019 and P = 0.009). Individuals in the highest tertile of energy-adjusted intake of fructose from fruit juice and SSB had a 1.04-fold (95% CI 0.99; 1.11) and 1.09-fold (95% CI 1.03; 1.16) higher IHL, respectively, in comparison with the lowest tertile in the fully adjusted models. Finally, the association for fructose from fruit juice was stronger in individuals with type 2 diabetes (P for interaction = 0.071). CONCLUSIONS: Fructose from fruit juice and SSB is independently associated with higher IHL. These cross-sectional findings contribute to current knowledge in support of measures to reduce the intake of fructose-containing beverages as a means to prevent nonalcoholic fatty liver disease at the population level.
OBJECTIVE: Epidemiological evidence regarding the relationship between fructose intake and intrahepatic lipid (IHL) content is inconclusive. We, therefore, assessed the relationship between different sources of fructose and IHL at the population level. RESEARCH DESIGN AND METHODS: We used cross-sectional data from The Maastricht Study, a population-based cohort study (n = 3,981; mean ± SD age: 60 ± 9 years; 50% women). We assessed the relationship between fructose intake (assessed with a food-frequency questionnaire)-total and derived from fruit, fruit juice, and sugar-sweetened beverages (SSB)-and IHL (quantified with 3T Dixon MRI) with adjustment for age, sex, type 2 diabetes, education, smoking status, physical activity, and intakes of total energy, alcohol, saturated fat, protein, vitamin E, and dietary fiber. RESULTS: Energy-adjusted total fructose intake and energy-adjusted fructose from fruit were not associated with IHL in the fully adjusted models (P = 0.647 and P = 0.767). In contrast, energy-adjusted intake of fructose from fruit juice and SSB was associated with higher IHL in the fully adjusted models (P = 0.019 and P = 0.009). Individuals in the highest tertile of energy-adjusted intake of fructose from fruit juice and SSB had a 1.04-fold (95% CI 0.99; 1.11) and 1.09-fold (95% CI 1.03; 1.16) higher IHL, respectively, in comparison with the lowest tertile in the fully adjusted models. Finally, the association for fructose from fruit juice was stronger in individuals with type 2 diabetes (P for interaction = 0.071). CONCLUSIONS: Fructose from fruit juice and SSB is independently associated with higher IHL. These cross-sectional findings contribute to current knowledge in support of measures to reduce the intake of fructose-containing beverages as a means to prevent nonalcoholic fatty liver disease at the population level.
Authors: Marja G J Veugen; Veronica G Onete; Ronald M A Henry; Hans-Peter Brunner-La Rocca; Annemarie Koster; Pieter C Dagnelie; Nicolaas C Schaper; Simone J S Sep; Carla J H van der Kallen; Martin P J van Boxtel; Koen D Reesink; Johannes S Schouten; Hans H C M Savelberg; Sebastian Köhler; Frans R Verhey; Joop P W van den Bergh; Miranda T Schram; Coen D A Stehouwer Journal: Sci Rep Date: 2022-05-05 Impact factor: 4.996