title: Fructose-Rich Beverage Intake and Central Adiposity, Uric Acid, and Pediatric Insulin Resistance.
abstract: OBJECTIVE
  To determine the association between sugar-sweetened beverage (SSB) consumption with biomarkers of insulin resistance (IR) and investigate whether/how this relates to obesity and serum uric acid in adolescents.
  
  
  METHODS
  Adolescents (n = 1454, aged 12-16 years) were assessed in a study conducted to monitor Multilevel Risk Profiles for Adolescent Metabolic Syndrome in Taiwan. Detailed information about demographics, diet, physical, anthropometric, and clinical variables was collected. An original homeostatic model assessment of IR (HOMA1-IR), updated nonlinear homeostatic model assessment of IR (HOMA2-IR) model, and several IR markers were measured.
  
  
  RESULTS
  Adolescents who consumed a greater amount of SSBs were more likely to have elevated fasting serum insulin, HOMA1-IR, and HOMA2-IR (P for trends, ≤.028). Compared with SSB nondrinkers, those with >350 mL/d intake of heavy high-fructose corn syrup-containing SSBs had a 0.52 and 0.30 higher multivariate-adjusted HOMA1-IR and HOMA2-IR, respectively. Waist circumference and serum uric acid were correspondingly found to explain 25.4% and 23.6%, as well as 23.2% and 20.6%, of the increases in the 2 IR markers. Both the elevations of HOMA1-IR and HOMA2-IR for high-fructose corn syrup-rich SSB intake were strengthened among obese adolescents (P for interaction, ≤.033).
  
  
  CONCLUSIONS
  Fructose-rich SSB intake is associated with elevated levels of IR, and this relationship may be partially mediated by central adiposity and serum uric acid. Obesity may modify the effect of this type of SSB consumption in intensifying the elevation of IR in adolescents.
authors.affiliation: Institute of Environmental and Occupational Health Sciences, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Te-Fu
authors.initials: TF
authors.lastname: Chan
authors.affiliation: Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hsiao-Ling
authors.initials: HL
authors.lastname: Huang
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
authors.forename: Sharon
authors.initials: S
authors.lastname: Tsai
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Wu
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Yang
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Tsu-Nai
authors.initials: TN
authors.lastname: Wang
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Taipei, Taiwan. Electronic address: cnhung@kmu.edu.tw.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001628:Beverages; D015415:Biomarkers / Q000097:blood; D002648:Child; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D005632:Fructose / Q000009:adverse effects*; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009043:Motor Activity; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000097:blood / Q000503:physiopathology*; D063766:Pediatric Obesity / Q000097:blood / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013624:Taiwan; D014527:Uric Acid / Q000097:blood*; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D014527:Uric Acid; D005632:Fructose