The association between the amount and sources of
fructose intake with
insulin sensitivity and liver fat needs further elucidation. This study aimed at examining whether habitual intake of
sucrose plus non-
sucrose bound as well as of non-
sucrose bound
fructose (total
fructose, fruit-derived, juice-derived, sugar sweetened beverages (SSB)-derived
fructose) is cross-sectionally associated with
insulin sensitivity and
fatty liver index (FLI).
Fructose intake was estimated using the EPIC food frequency questionnaire from 161 participants with
type 2 diabetes (T2D) in the ongoing German Diabetes Study (GDS) (age 53 ± 9 years; HbA1c 6.4 ± 0.9%) and 62 individuals without diabetes (CON) (47 ± 14 years; 5.3 ± 0.3%). Peripheral (M-value) and hepatic
insulin resistance were assessed by hyperinsulinemic-euglycemic clamps with stable
isotope dilution. FLI was calculated based on body mass index, waist circumference,
triglyceride and gamma glutamyl
transferase concentrations. Multivariable linear regression analyses were performed. A doubling of SSB-derived
sucrose plus non-
sucrose bound as well as of non-
sucrose bound
fructose intake was independently associated with a reduction of the M-value by -2.6% (-4.9; -0.2) and -2.7% (-5.2; -0.1) among T2D, respectively, with an increase in the odds of
fatty liver by 16% and 17%, respectively among T2D (all p < 0.05). Doubling fruit-derived
sucrose plus non-
sucrose bound
fructose intake independently related to a reduction in the odds of
fatty liver by 13% (p = 0.033) among T2D. Moderate SSB-derived
fructose intake may detrimentally affect peripheral
insulin sensitivity, whereas fruit-derived
fructose intake appeared beneficial for liver fat content.