FIGURE 4.

Elevated fructose intake trigger fatty liver disease. Consumed sugar such as fructose moves from the intestinal lumen to the blood circulation through a facilitated passive transport across the apical border of enterocytes using the facilitative glucose/fructose transporter GLUT5. It is then transported into the liver through the hepatic portal vein. In the liver fructose is metabolized to glucose and drives lipid synthesis resulting in steatosis, elevated concentrations of triglycerides, and adiposity. Under physiological conditions, these processes are tightly regulated finely adjusted in crosstalk with the brain, which integrates signals impacting food intake, energy expenditure, insulin secretion, hepatic glucose production, and fatty acid metabolism. For details see text. Abbreviations used are: APOC3, apolipoprotein C-III; ANGPTL8, angiopoietin-like eight; FGF21, fibroblast growth factor 21; VLDL, very low density lipoprotein. Adapted from (Hannou et al., 2018).