Reuters Health Information: Fructose tied to advanced liver disease in children and teens
Fructose tied to advanced liver disease in children and teens
Last Updated: 2017-02-21
By Lisa Rapaport
(Reuters Health) - Obese youth with non-alcoholic fatty
liver disease (NAFLD) and a diet high in fructose may be more
likely to develop serious chronic liver damage common in adult
alcoholics, a study suggests.
NAFLD is the most common liver disease in western children,
the authors point out in the Journal of Hepatology, online
February 14. It is now recognized as the liver�s "manifestation"
of metabolic syndrome, they add.
For their study, Dr. Valerio Nobili of Bambino Gesu
Children's Hospital in Rome and colleagues examined data on 271
obese children and teens with NAFLD. About 38 percent of them
(n=102) had more extensive liver damage (nonalcoholic
Participants underwent liver biopsies to assess fat
accumulation. Fructose consumption was assessed by food
frequency questionnaire, and uric acid was measured in serum.
Hyperuricemia (uric acid 5.9 mg/dl or greater) was present
in 47% of patients with NASH compared with 29.7% of non-NASH
patients (p=0.003), the researchers report.
Both uric acid concentration (odds ratio, 2.48, 95% CI:
1.87�2.83, p=0.004) and fructose consumption (OR, 1.61, 95% CI
1.25�1.86, p=0.001) were independently associated with NASH,
after adjustment for multiple (and all) measured confounders,
Fructose consumption was also independently associated with
hyperuricemia (OR, 2.02, 95% CI: 1.66�2.78, p=0.01). The youth
with NASH had higher average consumption of fructose. Their
median intake was about 70 grams of fructose daily. Median
fructose consumption of children and teens without NASH was
about 53 grams a day.
One limitation of the study is that it relied on children
and teens to accurately recall and report what they ate, the
authors note. The study also didn't examine whether there was a
difference in liver outcomes based on how much fructose
participants got from whole fruits, fruit juices or sodas.
"Our understanding of the role of fructose in fatty liver is
still evolving," said Dr. Jeffrey Schwimmer, a researcher at the
University of California, San Diego and director of the Fatty
Liver Clinic at Rady Children's Hospital.
"We don't think that the impact of fructose from fruit is
the same as fructose from drinks," Schwimmer, who wasn't
involved in the study, said by email.
The difference in fructose consumption between youth with
and without NASH in the study would be in one glass of sweetened
tea or soda, but also the amount a child might get from pears or
grapes, Schwimmer added.
He advises parents to "limit added sugars while further
research is done to better understand" how fructose impacts the
J Hepatol 2017.