The Small Intestine Converts Dietary Fructose into Glucose and Organic Acids. Author Cholsoon Jang, Sheng Hui, Wenyun Lu, Alexis Cowan, Raphael Morscher, Gina Lee, Wei Liu, Gregory Tesz, Morris Birnbaum, Joshua Rabinowitz Publication Year 2018 Type Journal Article Abstract Excessive consumption of sweets is a risk factor for metabolic syndrome. A major chemical feature of sweets is fructose. Despite strong ties between fructose and disease, the metabolic fate of fructose in mammals remains incompletely understood. Here we use isotope tracing and mass spectrometry to track the fate of glucose and fructose carbons in vivo, finding that dietary fructose is cleared by the small intestine. Clearance requires the fructose-phosphorylating enzyme ketohexokinase. Low doses of fructose are ∼90% cleared by the intestine, with only trace fructose but extensive fructose-derived glucose, lactate, and glycerate found in the portal blood. High doses of fructose (≥1 g/kg) overwhelm intestinal fructose absorption and clearance, resulting in fructose reaching both the liver and colonic microbiota. Intestinal fructose clearance is augmented both by prior exposure to fructose and by feeding. We propose that the small intestine shields the liver from otherwise toxic fructose exposure. Keywords Animals, Glucose, Liver, Models, Biological, Mice, Inbred C57BL, Metabolome, Isotope Labeling, Feeding Behavior, Microbiota, Carboxylic Acids, Dietary Carbohydrates, Fructose, Intestine, Small Journal Cell Metab Volume 27 Issue 2 Pages 351-361.e3 Date Published 02/2018 ISSN Number 1932-7420 DOI 10.1016/j.cmet.2017.12.016 Alternate Journal Cell Metab. PMCID PMC6032988 PMID 29414685 PubMedPubMed CentralGoogle ScholarBibTeXEndNote X3 XML