Fructose and nonalcoholic fatty liver disease

Abstract

Nonalcoholic fatty liver disease (NAFLD) is an important emerging public health problem which is expanding worldwide. NAFLD is the liver component of the metabolic syndrome, frequently associated with obesity, type 2 diabetes (T2DM) and cardiovascular disease. The high intake of high fructose corn syrups (HFCS) and refined carbo-hydrates registered in the last decades could be partly responsible for the current epidemics of obesity and T2DM. Due to the existence of a ‘‘fructose pathway’’, high fructose intake provides an uncontrolled amount of substrates forde novolipogenesis. The mechanism by which fructose activates lipogenesis is complex and involves several transcription regulators. Other mechanisms involved in the process by which the high fructose intake induces NAFLD are the inflammatory cascade, the hepatic leptin resistance and the reprogramming of genes involved in lipid and carbo-hydrate metabolism through epigenetic mechanisms.