Fructose transport mechanisms in humans

Background & Aims: The possible mechanisms of fructose transport ave diffusion, a disaccharidase-related transport system, and glucose-facilitated fructose transport. However, these mechanisms in the human small intestine have not been systematically examined. This study was designed to investigate the mechanisms of fructose transport in the human duodenojejunum. Methods: A triple-lumen tube was fluoroscopically positioned in the duodenojejunum of 7 men, Nine carbohydrate-electrolyte solutions were perfused at the rate of 15 mL/min. Acarbose and lactulose were used to examine the disaccharidase-related transport system and glucose-facilitated fructose transport, respectively. Results: Fructose absorption was greater (P < 0.05) from fructose-glucose (FruGlu) and fructose-glucose-acarbose (FruGluA) solutions than from fructose-mannitol (FruMann) and fructose-mannitol-acarbose (FruMannA) solutions, but there was no difference between FruGlu and FruGluA solutions. A sucrose solution produced greater (P < 0.05) sucrose absorption than a sucrose-acarbose solution. Lactulose absorption (0.016-0.039 mmol.h(-1).cm(-1)) was observed from solutions containing glucose or sucrose. Water absorption was not different among sucrose, FruGlu, and glucose solutions. FruMann solution produced net water secretion, These data suggest that free fructose and glucose transport were not inhibited by acarbose and that the presence of glucose induced lactulose absorption and enhanced fructose absorption. Conclusions: Fructose is transported transcellularly by facilitated diffusion and paracellularly (based on lactulose transport) via glucose-activated solution drag. In the human small intestine, free fructose and glucose transport does not occur via the disaccharidase system.