title: Short-term isocaloric fructose restriction lowers apoC-III levels and yields less atherogenic lipoprotein profiles in children with obesity and metabolic syndrome.
abstract: Dietary fructose may play a role in the pathogenesis of metabolic syndrome (MetS). In a recently published study of obese children with MetS, we showed that isocaloric fructose restriction reduced fasting triglyceride (TG) and LDL-cholesterol (LDL-C). In these ancillary analyses, we tested the hypothesis that these effects were also accompanied by improved quantitative and qualitative changes in LDL and HDL subclasses and their apolipoproteins; as well as change in VLDL, particularly apoC-III.
  
  
  
  Obese children with MetS (n = 37) consumed a diet that matched self-reported macronutrient composition for nine days, with the exception that dietary fructose was reduced from 11.7 ± 4.0% to 3.8 ± 0.5% of daily calories and substituted with glucose (in starch). Participants underwent fasting biochemical analyses on Days 0 and 10. HDL and LDL subclasses were analyzed using the Lipoprint HDL and LDL subfraction analysis systems from Quantimetrix.
  
  
  
  Significant reductions in apoB (78 ± 24 vs. 66 ± 24 mg/dl) apoC-III (8.7 ± 3.5 vs. 6.5 ± 2.6 mg/dl) and apoE (4.6 ± 2.3 vs. 3.6 ± 1.1 mg/dl), all p < 0.001) were observed. LDL size increased by 0.87 Å (p = 0.008). Small dense LDL was present in 25% of our cohort and decreased by 68% (p = 0.04). Small HDL decreased by 2.7% (p < 0.001) and large HDL increased by 2.4% (p = 0.04). The TG/HDL-C ratio decreased from 3.1 ± 2.5 to 2.4 ± 1.4 (p = 0.02). These changes in fasting lipid profiles correlated with changes in insulin sensitivity.
  
  
  
  Isocaloric fructose restriction for 9 days improved lipoprotein markers of CVD risk in children with obesity and MetS. The most dramatic reduction was seen for apoC-III, which has been associated with atherogenic hypertriglyceridemia.
authors.affiliation: Dept. of Research, College of Osteopathic Medicine, Touro University-California, Vallejo, CA, USA. Electronic address: alejandro.gugliucci@tu.edu.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gugliucci
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Lustig
authors.affiliation: Dept. of Research, College of Osteopathic Medicine, Touro University-California, Vallejo, CA, USA.
authors.forename: Russell
authors.initials: R
authors.lastname: Caccavello
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA, USA.
authors.forename: Ayca
authors.initials: A
authors.lastname: Erkin-Cakmak
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Noworolski
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Viva W
authors.initials: VW
authors.lastname: Tai
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wen
authors.affiliation: Dept. of Research, College of Osteopathic Medicine, Touro University-California, Vallejo, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mulligan
authors.affiliation: Basic Sciences, College of Osteopathic Medicine, Touro University-California, Vallejo, CA, USA.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Schwarz
mesh_terms: D000293:Adolescent; D001741:Black or African American; D053305:Apolipoprotein C-III / Q000097:blood*; D050197:Atherosclerosis; D002648:Child; D004032:Diet; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005632:Fructose / Q000008:administration & dosage*; D005947:Glucose / Q000737:chemistry; D006630:Hispanic or Latino; D006801:Humans; D008074:Lipoproteins / Q000378:metabolism; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications / Q000178:diet therapy*; D063766:Pediatric Obesity / Q000097:blood* / Q000150:complications / Q000178:diet therapy*; D014280:Triglycerides / Q000097:blood
chemical_list: D053305:Apolipoprotein C-III; C034396:HDL-triglyceride; D008074:Lipoproteins; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D008079:Lipoproteins, VLDL; D014280:Triglycerides; D005632:Fructose; D005947:Glucose
keywords: Apolipoproteins; Fructose; HDL subclasses; LDL subclasses; Metabolic syndrome; Obesity; apoC-III