American Diabetes Association
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Fasting Serum Fructose Levels Are Associated with Risk of Incident Type 2 Diabetes in Middle-aged and Older Chinese Population

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posted on 2020-07-01, 21:07 authored by Ying Chen, Huandong Lin, Li Qin, Youli Lu, Lin Zhao, Mingfeng Xia, Jingjing Jiang, Xiaomu Li, Chen Yu, Geng Zong, Yan Zheng, Xin Gao, Qing Su, Xiaoying Li

We investigated the relationship between fasting serum fructose levels and the risk of incident type 2 diabetes in a prospective Chinese cohort.


Among 949 community-based participants aged ≥ 40 years old without diabetes at baseline, fasting serum fructose levels were measured using liquid chromatography-tandem mass spectrometry. The participants were followed up for the occurrence of diabetes. Cox regression models were performed to analyze the effect of fasting serum fructose levels on risk of incident diabetes.


During a median of 3.5 years follow-up, 179 of 949 (18.9%) subjects developed type 2 diabetes. Elevated fasting serum fructose levels were associated with an increased risk of incident diabetes in a dose-response manner. After adjusting for age, sex, body mass index(BMI), lipid profiles, blood pressure, liver function, smoking and drinking status, baseline glucose level and sugar sweetened beverage(SSB) consumption, 1-SD increased fasting fructose level was associated with 35% (95% confidence interval:1.08-1.67) increased risk of developing diabetes. After further adjustment for serum uric acid and eGFR, the association was partially attenuated (hazard ratio,1.33; 95% confidence interval, 1.07-1.65). The association was similar by age, prediabetes status, BMI, and family history of diabetes, but attenuated in women(P for heterogeneity=0.037).


Elevated fasting serum fructose levels were independently associated with increased risk of incident type 2 diabetes in middle-aged and older Chinese population. Our data suggest higher fasting serum fructose levels might serve as a biomarker and/or a contributor to incident diabetes.


This work is supported by the grants from National Key Research and Development Program (Nos.2016YFC1304801, 2017YFC1310703), Shanghai Science and Technology Commission (18411951804, 17411962900), Shanghai Municipal Science and Technology Major Project (Grant No. 2017SHZDZX01).