A fructose based meal challenge to assess metabotypes and their metabolic risk profile. A randomized, crossover, controlled trial

Abstract Objectives Firstly, subjects were metabotyped based on the assessment of the postprandial glycemic, triglycerides and insulin response after the ingestion of a high protein meal challenge containing either high glucose (high GI) or fructose (low GI). Secondly, baseline characteristics were compared between the different metabotypes. Methods The study included 46 Asian women with a BMI between 17-28 kg/m2 in a randomized cross-over design. Baseline and 4 hour postprandial blood samples were collected and glucose, insulin and triglycerides (TG) were analyzed. Cluster analysis was used to phenotype the subjects in distinct groups. Baseline characteristics including anthropometry, glycaemic and lipid profile and resting metabolic rate were compared among the metabotypes. Results Cluster analysis revealed that subjects can be grouped into three metabotypes based on postprandial glucose, insulin and TG response following the fructose meal challenge: cluster 1 with an average glucose+high TG response (highTG) (n=12), cluster 2 with a high glucose+average TG response (highGLU) (n=8) and cluster 3 with an average glucose+average TG response (Avg) (n=26). Post-hoc analysis revealed significantly higher waist/hip ratio and a worse lipid profile for the HighTG cluster and higher fasting blood glucose, BMI, overall fat percentage and hip circumference in the HighGLU cluster. Conclusions Three metabotypes with a distinct metabolic response could be distinguished after a high fructose meal. The results suggest a different risk profile and may indicate why some people do and others don't develop diabetes in an obesogenic environment. Improved metabotype assessment will enable us to develop and optimize nutritional and medical interventions for people with differing diabetes risk.