Patients with MASLD exhibit in vivo changes in hepatic response to oral fructose consumption

Area of Science:

• Hepatology
• Metabolic Disorders
• Medical Imaging

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) involves altered liver metabolism.
• Fructose is a common dietary component that can impact hepatic energy metabolism.

Purpose of the Study:

• To compare in vivo hepatic phosphate metabolite changes using phosphorus magnetic resonance spectroscopy (31P-MRS) in patients with and without MASLD after fructose consumption.
• To investigate the impact of fructose on adenosine triphosphate (ATP) and other phosphate metabolites in the liver.

Main Methods:

• Thirty-seven overweight or obese patients without diabetes were enrolled.
• Participants underwent oral glucose tolerance tests, proton magnetic resonance spectroscopy (1H-MRS), and 31P-MRS.
• 31P-MRS was performed before and after a 75-gram oral fructose challenge to assess hepatic phosphate metabolites.

Main Results:

• In healthy individuals, fructose consumption led to increased phosphomonoesters (PME) and inorganic phosphate, with a significant drop in ATP.
• Patients with MASLD showed blunted responses, with unchanged PME and a delayed inorganic phosphate increase.
• ATP levels in MASLD patients showed a non-significant drop and recovered to baseline levels faster than in healthy individuals.

Conclusions:

• MASLD patients exhibit distinct hepatic phosphate metabolite changes following fructose consumption.
• These findings indicate altered hepatic metabolic handling of fructose in MASLD.
• The observed metabolic differences may have implications for MASLD progression.