title: Altered Brain Response to Drinking Glucose and Fructose in Obese Adolescents.
abstract: Increased sugar-sweetened beverage consumption has been linked to higher rates of obesity. Using functional MRI, we assessed brain perfusion responses to drinking two commonly consumed monosaccharides, glucose and fructose, in obese and lean adolescents. Marked differences were observed. In response to drinking glucose, obese adolescents exhibited decreased brain perfusion in brain regions involved in executive function (prefrontal cortex [PFC]) and increased perfusion in homeostatic appetite regions of the brain (hypothalamus). Conversely, in response to drinking glucose, lean adolescents demonstrated increased PFC brain perfusion and no change in perfusion in the hypothalamus. In addition, obese adolescents demonstrated attenuated suppression of serum acyl-ghrelin and increased circulating insulin level after glucose ingestion; furthermore, the change in acyl-ghrelin and insulin levels after both glucose and fructose ingestion was associated with increased hypothalamic, thalamic, and hippocampal blood flow in obese relative to lean adolescents. Additionally, in all subjects there was greater perfusion in the ventral striatum with fructose relative to glucose ingestion. Finally, reduced connectivity between executive, homeostatic, and hedonic brain regions was observed in obese adolescents. These data demonstrate that obese adolescents have impaired prefrontal executive control responses to drinking glucose and fructose, while their homeostatic and hedonic responses appear to be heightened. Thus, obesity-related brain adaptations to glucose and fructose consumption in obese adolescents may contribute to excessive consumption of glucose and fructose, thereby promoting further weight gain.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT ania.jastreboff@yale.edu sonia.caprio@yale.edu.
authors.forename: Ania M
authors.initials: AM
authors.lastname: Jastreboff
authors.affiliation: Department of Psychiatry, Yale Stress Center, Yale University School of Medicine, New Haven, CT Child Study Center, Yale University School of Medicine, New Haven, CT.
authors.forename: Rajita
authors.initials: R
authors.lastname: Sinha
authors.affiliation: Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT.
authors.forename: Jagriti
authors.initials: J
authors.lastname: Arora
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Giannini
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kubat
authors.affiliation: Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT.
authors.forename: Saima
authors.initials: S
authors.lastname: Malik
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Van Name
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Nicola
authors.initials: N
authors.lastname: Santoro
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Mary
authors.initials: M
authors.lastname: Savoye
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Elvira J
authors.initials: EJ
authors.lastname: Duran
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Bridget
authors.initials: B
authors.lastname: Pierpont
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
authors.forename: Gary
authors.initials: G
authors.lastname: Cline
authors.affiliation: Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT.
authors.forename: R Todd
authors.initials: RT
authors.lastname: Constable
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sherwin
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT ania.jastreboff@yale.edu sonia.caprio@yale.edu.
authors.forename: Sonia
authors.initials: S
authors.lastname: Caprio
mesh_terms: D000293:Adolescent; D001628:Beverages; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005260:Female; D005632:Fructose / Q000494:pharmacology*; D059907:Functional Neuroimaging; D054439:Ghrelin / Q000097:blood; D005947:Glucose / Q000494:pharmacology*; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007328:Insulin / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D009765:Obesity / Q000000981:diagnostic imaging / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D054439:Ghrelin; D007328:Insulin; D005632:Fructose; D005947:Glucose