Hepatic response to fructose altered in patients with MASLD

Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) show clear patterns of change in phosphate metabolites following oral fructose consumption, suggesting differences in hepatic metabolic response, according to a study.

Thirty-seven patients with obesity or overweight but without diabetes underwent a 2-h oral glucose tolerance testing, a fasting liver proton magnetic resonance spectroscopy, and a phosphorus magnetic resonance spectroscopy before and during 60 min after an oral 75-g fructose challenge.

No significant between-group differences were observed in adenosine triphosphate (ATP), phosphomonoesters (PME), or phosphodiesters prior to fructose consumption. However, after consumption, patients without MASLD demonstrated a rapid increase in PME from 15.5 to 19.3 within 15 min (p=0.033).

In these patients, inorganic phosphate initially dropped during the first 30 min but eventually increased from 10.2 to 11.8 (p=0.037), resulting in higher-than-baseline levels.

Patients without MASLD showed a significant decrease in ATP from 21.8 to 19.9 within 15 min (p=0.018), with persistently lower levels after 60 min (19.1; p=0.006 vs baseline).

However, all responses to oral fructose consumption seemed diminished in patients with MASLD. PME levels remained unchanged, and only inorganic phosphate increased 45 min after fructose consumption. Furthermore, ATP levels showed a nonsignificant decrease in the first 15 min, with recovery of baseline levels at 30 min.

“These findings suggest altered hepatic metabolic handling of fructose in MASLD, which may have implications for disease progression,” the researchers said.