1)
https://www.nature.com/articles/ncpneph0019
Hypothesis:
fructose-induced hyperuricemia as a causal mechanism for the epidemic of the
metabolic syndrome
The increasing incidence of obesity and the metabolic
syndrome over the past two decades has coincided with a marked increase in
total fructose intake. Fructose—unlike other sugars—causes serum uric acid
levels to rise rapidly. We recently reported that uric
acid reduces levels of endothelial nitric oxide (NO), a key mediator of insulin
action. NO increases blood flow to skeletal muscle and enhances glucose uptake.
Animals deficient in endothelial NO develop insulin resistance and other
features of the metabolic syndrome. As such, we propose that the epidemic of the metabolic
syndrome is due in part to fructose-induced hyperuricemia that reduces
endothelial NO levels and induces insulin resistance. Consistent
with this hypothesis is the observation that changes in mean
uric acid levels correlate with the increasing prevalence of metabolic syndrome
in the US and developing countries. In addition, we observed that a serum
uric acid level above 5.5 mg/dl independently predicted the development of
hyperinsulinemia at both 6 and 12 months in nondiabetic patients with
first-time myocardial infarction. Fructose-induced
hyperuricemia results in endothelial dysfunction and insulin resistance, and might be a novel
causal mechanism of the metabolic syndrome. Studies in humans should be
performed to address whether lowering uric acid levels will help to prevent
this condition.
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
2)
http://www.sciencedirect.com/science/article/pii/0026049572901205
Metabolism
Volume
21, Issue 8, August
1972,
Pages 713-721
Studies
on the mechanism of fructose-induced hyperuricemia in man
Irving Fox and William Kelley
Abstract
The rapid intravenous infusion
of fructose produces a transient increase in plasma urate concentration, as
well as an increase in the urinary excretion of oxypurines and uric acid.
Fructose-induced hyperuricemia and hyperuricaciduria is associated with a
striking increase in the blood lactate concentration, a decrease in erythrocyte
phosphoribosylpyrophosphate (PP-ribose-P) and ribose-5-phosphate concentration,
and no detectable change in erythrocyte ATP concentration. Although
pretreatment with allopurinol prevents the hyperuricemic effect of fructose,
the increase in plasma lactate is not modified and the increase in urinary
oxypurine excretion is enhanced. These results are consistent with the
hypothesis, based on previous studies in the rat, that fructose-induced
hyperuricemia in man results from an increased degradation of purine
ribonucleotides.