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Fructose metabolism

All three dietary monosaccharides are transported into the liver by the GLUT2 transporter.[33] Fructose and galactose are phosphorylated in the liver by fructokinase (Km= 0.5 mM) and galactokinase (Km = 0.8 mM). By contrast, glucose tends to pass through the liver (Km of hepatic glucokinase = 10 mM) and can be metabolised anywhere in the body.

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Liver function

While a few other tissues (e.g., sperm cells[59] and some intestinal cells) do use fructose directly, fructose is metabolized primarily in the liver.[60]

Compared with consumption of high glucose beverages, drinking high fructose beverages with meals results in lower circulating insulin and leptin levels, and higher ghrelin levels after the meal.[61] Since leptin and insulin decrease appetite and ghrelin increases appetite, some researchers suspect that eating large amounts of fructose increases the likelihood of weight gain.[62]

Excessive fructose consumption may contribute to the development of non-alcoholic fatty liver disease.

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Gout

A 2008 study found a substantial risk of incident gout associated with the consumption of fructose or fructose rich foods.[64] Cases of gout have risen in recent years, despite commonly being thought of as a Victorian disease, and it is suspected that the fructose found in soft drinks (e.g., carbonated beverages) and other sweetened drinks is the reason for this.