Science

TAKAHIRO KAWASAKI, MD
HIROSHI AKANUMA, PHD
TOSHIKAZU YAMANOUCHI, MD, PHD

OBJECTIVE — To investigate fructose metabolic changes in patients with diabetes.

RESEARCH DESIGN AND METHODS — Serum and urinary fructose concentrations were determined in healthy subjects (n = 23) and in nondiabetic (n = 23) and diabetic patients (n = 26). Fructose was measured using our newly developed method, and 13C6-fructose was used as the internal standard. After adding sample to a fixed amount of internal standard, ion-exchange resins and high-performance liquid chromatography pretreatments were per- formed. Then, the amount of fructose in the sample was measured by gas chromatography–mass spectrometry.

RESULTS — Serum fructose concentrations in patients with diabetes (12.0 ± 3.8 mol/l) were significantly higher than those in healthy subjects (8.1 ± 1.0 mol/l, P < 0.001) and nondiabetic patients (7.7 ± 1.6 mol/l, P < 0.001), and daily urinary fructose excretion was significantly greater in patients with diabetes (127.8 + 106.7 mol/day) than in nondiabetic patients (37.7 ± 23.0 mol/day, P < 0.001). In patients with diabetes (n = 20), serum fructose concentrations (8.6 ± 1.8 mol/l, P < 0.001) and daily urinary fructose excretion (63.4 ± 63.8 mol/day, P < 0.01) significantly decreased by week 2 after admission. CONCLUSIONS — The present results differed from those of previous studies in that we found that the serum and urinary fructose concentrations decreased rapidly, concomitant with an improvement in glycemia. Therefore, hyperglycemia was associated with increased serum and urinary fructose concentrations in patients with diabetes.