The role of fructose transporters in diseases linked to excessive fructose intake

J Physiol. 2013 Jan 15;591(2):401-14. doi: 10.1113/jphysiol.2011.215731. Epub 2012 Nov 5.

Abstract

Fructose intake has increased dramatically since humans were hunter-gatherers, probably outpacing the capacity of human evolution to make physiologically healthy adaptations. Epidemiological data indicate that this increasing trend continued until recently. Excessive intakes that chronically increase portal and peripheral blood fructose concentrations to >1 and 0.1 mm, respectively, are now associated with numerous diseases and syndromes. The role of the fructose transporters GLUT5 and GLUT2 in causing, contributing to or exacerbating these diseases is not well known. GLUT5 expression seems extremely low in neonatal intestines, and limited absorptive capacities for fructose may explain the high incidence of malabsorption in infants and cause problems in adults unable to upregulate GLUT5 levels to match fructose concentrations in the diet. GLUT5- and GLUT2-mediated fructose effects on intestinal electrolyte transporters, hepatic uric acid metabolism, as well as renal and cardiomyocyte function, may play a role in fructose-induced hypertension. Likewise, GLUT2 may contribute to the development of non-alcoholic fatty liver disease by facilitating the uptake of fructose. Finally, GLUT5 may play a role in the atypical growth of certain cancers and fat tissues. We also highlight research areas that should yield information needed to better understand the role of these GLUTs in fructose-induced diseases.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Carbohydrate Metabolism, Inborn Errors / etiology
  • Carbohydrate Metabolism, Inborn Errors / genetics
  • Dietary Carbohydrates / adverse effects
  • Dietary Carbohydrates / metabolism
  • Fatty Liver / etiology
  • Fructose / adverse effects
  • Fructose / metabolism*
  • Gene Expression
  • Glucose Transporter Type 2 / genetics
  • Glucose Transporter Type 2 / metabolism*
  • Glucose Transporter Type 5 / genetics
  • Glucose Transporter Type 5 / metabolism*
  • Humans
  • Hypertension / etiology
  • Intestinal Absorption / genetics
  • Intestinal Absorption / physiology
  • Malabsorption Syndromes / etiology
  • Malabsorption Syndromes / genetics
  • Non-alcoholic Fatty Liver Disease

Substances

  • Dietary Carbohydrates
  • Glucose Transporter Type 2
  • Glucose Transporter Type 5
  • Fructose

Supplementary concepts

  • Glucose-Galactose Malabsorption