Dietary fructose intake in obese children and adolescents: relation to procollagen type III N-terminal peptide (P3NP) and non-alcoholic fatty liver disease

J Pediatr Endocrinol Metab. 2016 Dec 1;29(12):1345-1352. doi: 10.1515/jpem-2016-0015.


Background: Excessive use of fructose has been incriminated as a risk factor for hepatic steatosis. Procollagen type III N-terminal peptide (P3NP) is a marker for steatohepatitis. Thus, we aimed to assess fructose intake in obese children and its relation to nonalcoholic fatty liver disease (NAFLD) and P3NP.

Methods: Fifty-five obese children were compared to 30 controls. All were subjected to dietary fructose and anthropometric assessment, fasting blood sugar (FBS), fasting insulin (FI) and homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile, uric acid, alanine aminotransferase (ALT), P3NP and abdominal ultrasound.

Results: Patients had higher fructose intake which was associated with increased NAFLD grade. There was an increase in P3NP with increased NAFLD grade. P3NP correlated positively with fructose intake (processed sources and total) and caloric intake.

Conclusions: High fructose intake is associated with NAFLD and P3NP may serve as a marker of NAFLD in obese children with a proposed cutoff value of 8.5 ng/mL.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Anthropometry
  • Biomarkers / blood*
  • Case-Control Studies
  • Child
  • Cross-Sectional Studies
  • Diet / adverse effects*
  • Energy Intake
  • Female
  • Fructose / administration & dosage
  • Fructose / adverse effects*
  • Humans
  • Insulin Resistance
  • Male
  • Non-alcoholic Fatty Liver Disease / blood
  • Non-alcoholic Fatty Liver Disease / diagnosis*
  • Non-alcoholic Fatty Liver Disease / etiology
  • Obesity / complications*
  • Peptide Fragments / blood*
  • Procollagen / blood*
  • Prognosis
  • Risk Factors
  • Sweetening Agents / administration & dosage
  • Sweetening Agents / adverse effects


  • Biomarkers
  • Peptide Fragments
  • Procollagen
  • Sweetening Agents
  • procollagen Type III-N-terminal peptide
  • Fructose