BACKGROUND AND OBJECTIVE: Regarding the role of fructose in the synthesis of triglycerides, numerous studies have examined the association between fructose-containing artificial sweeteners and some chronic diseases. However, the studies which evaluated the role of fructose derived from natural sources with non-alcoholic fatty liver disease (NAFLD) were rare. Therefore, this study was designed to determine the relationship between dietary fructose intake and lipid profile in NAFLD patients.

METHODS: This case - control study was conducted on 57 patients with NAFLD (confirmed by ultrasonography and with high level of liver enzymes) and 57 homogenized healthy subjects in terms of age, sex and body mass index in Sheykh-ol-rais clinic in Tabriz. Food frequency questionnaires of 97 food items and 3-day food record were used to assess the consumption of fructose and sucrose. Serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase, triglyceride, total cholesterol and HDL-C levels were measured and LDL-C was estimated, too.

FINDINGS: The frequency of weekly fruit consumption and total fructose from energy intake was significantly higher in NAFLD patients than the control group (respectively 75.5 versus 63.4 times per week and p=0.004 and 1.5 vs. 1.2 and p=0.045) whereas no significant differences were found in the amount of daily fructose intake. NAFLD patients had higher serum triglycerides (161.22 vs. 131.12 mg/dl and p=0.015) and lower HDL-C levels (47.41 vs. 51.40 mg/dl and p=0.034) than healthy subjects. There was no significant relationship between fructose consumption and the weekly frequency of fructose-rich food consumption groups with serum triglyceride level in each group.

CONCLUSION: The results indicated that fructose derived from natural sources had no effect on serum triglyceride level and consequently on pathogenesis of NAFLD.