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Fructose Supplementation in Carriers for Hereditary Fructose Intolerance

Not Applicable
Completed
Conditions
Hereditary Fructose Intolerance
Interventions
Other: Experimental diet Fru rich diet
Other: Experimental low Fru diet
Registration Number
NCT03545581
Lead Sponsor
University of Lausanne
Brief Summary

This study aimed to examine metabolic response to a short-term fructose enriched diet in carriers for hereditary fructose intolerance compared to controls. Effects of fructose coffees will be assessed in 7 healthy volunteers and 7 subjects with heterozygous mutation for ALDOB gene in a randomized, controlled, crossover trial.

Detailed Description

A high fructose intake also increases blood lactate and uric acid concentrations. It has been proposed that uric acid may contribute to insulin resistance by impairing endothelium-dependent vasodilation, promoting pro-inflammatory effects and dyslipidemia by activating de novo lipogenesis.

These consequences of fructose overconsumption may be even more marked in individuals with hereditary alterations in fructose metabolism. Indeed, individuals with hereditary fructose intolerance (HFI), due to biallelic mutations in the gene coding for aldolase B (ALDOB), may develop acute, life-threatening manifestations when exposed to fructose. Heterozygous carriers of ALDOB mutation are quite common in the general population, with a predicted frequency ranging between 1:55 and 1:120. Few studies have examined the effect of fructose ingestion in heterozygotes subject for HFI. Heterozygous carriers are generally considered to have normal fructose metabolism since a \~ 50% level of aldolase B activity is presumed to be sufficient for adequate function. However, heterozygous carriers were reported to have enhanced uric acid responses to large intravenous and/or oral fructose loads.

Investigators hypothesized that heterozygous carriers may also have mild defects of fructose metabolism and/or a larger increase in cardiometabolic risk factors than the normal population after ingestion of moderate amounts of fructose.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
12
Inclusion Criteria
  • Case subjects: Heterozygous carriers for ALDOB mutation confirmed by molecular analysis
  • Control subjects: healthy individuals matched for weight and age to subjects
Exclusion Criteria
  • Fasting glucose > 7.0 mmol/L
  • Fasting triglycerides > 4.0 mmol/L
  • Chronic renal insufficiency (eGFR < 50 ml/min)
  • Drugs
  • Women who are pregnant or breast feeding
  • For women: lack of safe contraception
  • Alcool consumption > 30g/d
  • Inability to discern

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Experimental diet Fru rich dietExperimental diet Fru rich dietEnriched fructose diet from day 1 to day 7.
Experimental low Fru dietExperimental low Fru dietLow fructose diet from day 1 to day 7.
Primary Outcome Measures
NameTimeMethod
Metabolite concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

The primary endpoint is the change of metabolite concentration after ingestion of a test meal (oral glucose and fructose load) under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Secondary Outcome Measures
NameTimeMethod
Plasma triglycerides concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in triglycerides concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma insulin concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in insulin concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma urea concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in urea concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma amino acid concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in amino acid concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Urine creatinine concentrationTime Frame: 24 hour urine collection before ingestion of a test meal and after 7 days of 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Change in urine creatinine profile after low fructose diet and an enriched fructose diet according to a crossover design

Urine urea concentrationTime Frame: 24 hour urine collection before ingestion of a test meal and after 7 days of 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Change in urine urea profile after low fructose diet and an enriched fructose diet according to a crossover design

Urine uric acid concentrationTime Frame: 24 hour urine collection before ingestion of a test meal and after 7 days of 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Change in urine uric acid profile after low fructose diet and an enriched fructose diet according to a crossover design

Plasma fructose concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in fructose concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma creatinine concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in creatinine concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma ammonia concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in ammonia concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma aspartate transaminase (ASAT) concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in aspartate transaminase (ASAT) concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Urine metabolome concentrationTime Frame: 24 hour urine collection before ingestion of a test meal and after 7 days of 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Change in urine metabolome profile after low fructose diet and an enriched fructose diet according to a crossover design

Plasma uric acid concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in uric acid concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma lactate concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in lactate concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma phosphate concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in phosphate concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma metabolome concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in metabolome concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Blood pressureTime Frame: at baseline before study intervention and at the end of each conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Change of systolic and diastolic pressure after low fructose diet and an enriched fructose diet according to a crossover design

Plasma glucose concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in glucose concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Plasma alanine transaminase (ALAT) concentrationTime Frame: -30 min before ingestion of a test meal to 120 min after ingestion of a test meal

Change in alanine transminase (ALAT) concentration after ingestion of a test meal under 2 conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Body weightTime Frame: at baseline before study intervention and at the end of each conditions (enriched fructose diet vs poor fructose diet) according to a crossover design

Change of body weight after low fructose diet and an enriched fructose diet according to a crossover design

Trial Locations

Locations (1)

Guillaume Debray

🇧🇪

Liège, Belgium

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