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Dietary fructose feeds hepatic lipogenesis via microbiota-derived acetate
Open accessAbstract
Consumption of fructose has risen markedly in recent decades owing to the use of sucrose and high-fructose corn syrup in beverages and processed foods 1, and this has contributed to increasing rates of obesity and non-alcoholic fatty liver disease 2-4. Fructose intake triggers de novo lipogenesis in the liver 4-6, in which carbon precursors of acetyl-CoA are converted into fatty acids. The ATP citrate lyase (ACLY) enzyme cleaves cytosolic citrate to generate acetyl-CoA, and is upregulated after consumption of carbohydrates 7. Clinical trials are currently pursuing the inhibition of ACLY as a treatment for metabolic diseases 8. However, the route from dietary fructose to hepatic acetyl-CoA and lipids remains unknown. Here, using in vivo isotope tracing, we show that liver-specific deletion of Acly in mice is unable to suppress fructose-induced lipogenesis. Dietary fructose is converted to acetate by the gut microbiota 9, and this supplies lipogenic acetyl-CoA independently of ACLY 10. Depletion of the microbiota or silencing of hepatic ACSS2, which generates acetyl-CoA from acetate, potently suppresses the conversion of bolus fructose into hepatic acetyl-CoA and fatty acids. When fructose is consumed more gradually to facilitate its absorption in the small intestine, both citrate cleavage in hepatocytes and microorganism-derived acetate contribute to lipogenesis. By contrast, the lipogenic transcriptional program is activated in response to fructose in a manner that is independent of acetyl-CoA metabolism. These data reveal a two-pronged mechanism that regulates hepatic lipogenesis, in which fructolysis within hepatocytes provides a signal to promote the expression of lipogenic genes, and the generation of microbial acetate feeds lipogenic pools of acetyl-CoA.
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“an animal study found that dietary fructose could be converted to microbial acetate by the gut microbiota, which may enhance hepatic lipogenesis by supplying lipogenic acetyl-CoA independently of ATP citrate lyase.96”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [96]
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“In mice, dietary fructose is metabolized by gut microbes into acetate, serving as a source of acetyl-CoA for lipid synthesis [61].”
From The Gut–Brain–Microbiota Connection and Its Role in Autism Spectrum Disorders (2025) · cites this paper as [61]
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Fructose aggravates copper-deficiency-induced non-alcoholic fatty liver disease
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“Although the literature has summarized the effects of fructose on hepatocytes, it remains unknown how fructose directly impacts the function and phenotype of macrophages 31,32 .”
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Self-citationA diet high in FODMAPs as a novel dietary strategy in diabetes?
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“[9] assigned another function to the gut microbiome.”
BackgroundSome paradoxes and unresolved aspects of hepatic de novo lipogenesis
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“Finally, in the case of fructose,thereisevidencethatasigni fi cantfractionismetabolizedtoglucose and short-chain fatty acids in the intestine 34 .”
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Host and microbiome lipid metabolism in colorectal cancer development and therapy
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Liver-breast communication of adipocyte-oriented exosomes drives primary mammary cancer progression
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“…generates acetate to feed hepatic DNL, independent of ATP-citrate lyase (ACLY), the rate limiting enzyme for conversion of citrate to acetyl-CoA [62]. dual mechanism of substrate fl ux and upregulation of These data likely explain a dual mechanism of substrate flux and upregulation of DNL…”
BackgroundInfluentialJanota, B., & Szymanek, B. (2024) · Cancers · doi:10.3390/cancers16051030 · Cited by 13
“These errors, accompanying the development of visceral obesity and dyslipidemia, result in insulin resistance and the stimulation of de novo lipogenesis in the liver [12,13].”
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Lipidome is lipids regulator in gastrointestinal tract and it is a life collar in COVID-19: A review
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Interventions for non-alcoholic liver disease: a gut microbial metabolites perspective
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“Dietary fructose increases intestinal villus length in the duodenum and proximal jejunum by 25% to 40%, correlating with enhanced lipid absorption and accelerated obesity through modulation of the gut microbiome [ 42 , 115 ].”
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“SCFAs, including butyrate, propionate, and acetate, are enriched in MASLD-HCC patients and drive MASLD progression by regulating hepatic lipogenesis [198-202].”
Fructose: metabolic signal and modern hazard
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“Excess fructose intake can also lead to passage of fructose to the colon, where it can be metabolized to acetate, which subsequently can reach the portal vein and liver, to be converted to acetyl-CoA and fat 41 .”
Self-citationLncRNA Nron deficiency protects mice from diet-induced adiposity and hepatic steatosis
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“18,41,42 The RT-qPCR results revealed a significantly elevated expression of the pro-inflammatory polarization signature gene iNOS and pro-inflammatory cytokine genes of Tnfa , Il1b , and Il6 in both RAW 264.7 and IMG cells with fructose exposure ( + Fru) (Figure 1B,C).”
InfluentialRahman, S., Trone, K. E., Kelly, C. J., Stroud, A., & Martindale, R. G. (2022) · Current Gastroenterology Reports · doi:10.1007/s11894-022-00858-1 · Cited by 13
“Finally, high dietary fructose intake can increase the microbial-generated acetate substantially [96, 97].”
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“The inhibition of ACLY can be bypassed in some cancer cells [98] and in the livers of mice fed a high-fructose diet [96] through the upregulation of ACSS2.”
BackgroundZhang, C., Liu, S., Sui, Y., & Yang, M. J. (2025) · World Journal of Hepatology · doi:10.4254/wjh.v17.i11.113756 · Cited by 14
Added sugars, gut microbiota, and host health
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“…of triose-phosphate intermediates fuelling de novo lipogenesis, 115 upregulation of transcriptional regulators such as carbohydrate-responsive element-binding protein (ChREBP) and sterol regulatory element-binding protein-1c (SREBP-1c), 115 and gut microbiota-related bile acid metabolism.”
InfluentialIntracellular spatiotemporal metabolism in connection to target engagement
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Fucoidan, as a marine bioactive substance, has shown great potential in regulating the bone-gut axis
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“It is not known what fraction of this fructose underwent PP oxidation prior to lactate formation.”
BackgroundAcetyl-CoA synthesis in the skin is a key determinant of systemic lipid homeostasis
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“27 Hence, genetic studies of ACLY have been limited to cell-or tissue-specific knockouts (e.g., in adipose tissues, 28–30 liver, 31–34 pancreas, 14 myeloid cells, 35–37 and T cells 38,39 ).”
Self-citationMurine gut microbial interactions exert antihyperglycemic effects
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“Second, the gut microbiota regulates glucose and lipid metabolism by synthesizing functional metabolites [12–15].”
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“In addition to being energy substrates, SCFAs are also signaling molecules, which influences the development of NAFLD [6].”
InfluentialKRAS G12V mutation-selective requirement for ACSS2 in colorectal adenoma formation
Budagyan, K., Cannon, A. C., Chatoff, A. G., Benton, D., Kurimchak, A., Araiza‐Olivera, D., Gerasimova, A., Snyder, N. W., Duncan, J. S., Uribe‐Alvarez, C., et al. (2025) · Cell Reports · doi:10.1016/j.celrep.2025.115444 · Cited by 11
“39 In this study, we found that KRAS G12V mutants exhibited greater acetate incorporation into cytoplasmic acetyl-CoAs, and that Acss2 KO significantly affected the ability of KRAS G12V mutants to generate cholesterol esters but had no effect on other mutants.”
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Metadata
- Authors
- Zhao, S., Jang, C., Liu, J., Uehara, K., Gilbert, M., Izzo, L., Zeng, X., Trefely, S., Fernandez, S., Carrer, A., Miller, K. D., Schug, Z. T., Snyder, N. W., Gade, T. P., Titchenell, P. M., Rabinowitz, J. D., & Wellen, K. E.
- Affiliations
- University of Pennsylvania (US)
- Princeton University (US)
- Veneto Institute of Molecular Medicine (IT)
- The Wistar Institute (US)
- Temple University (US)
- Corresponding author
- Wellen, Kathryn E.
- ORCID
- Venue
- Nature
- Published
- 2020-03-18
- Volume
- 579
- Issue
- 7800
- Pages
- 586-591
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC7416516
- OpenAlex
- W3012090404
- Cited by
- 553
- References
- 50
- Citations by year
- 2026: 61 · 2025: 90 · 2024: 91 · 2023: 96 · 2022: 91 · 2021: 82 · 2020: 42
- FWCI
- 59.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Padua Research Archive (University of Padova) (submittedVersion)
- Funders
- National Cancer Institute (T32CA115299, R01CA174761, F99CA222741, R01CA228339, T32CA009171, P30CA010815)
- National Institute of General Medical Sciences (R01GM132261, T32GM007229, K12GM081259)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK116005, DP1DK113643, K01DK111715, P30DK019525, T32DK007314)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (T32AR053461)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R03HD092630)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Lipid metabolism and biosynthesis
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Keywords
- dietary fructose, hepatic lipogenesis, de novo lipogenesis, gut microbiota, acetate, acetyl-CoA, ATP citrate lyase, ACSS2, fructolysis, non-alcoholic fatty liver disease, obesity, isotope tracing, lipogenic gene expression, fructose absorption
- MeSH terms
- Gastrointestinal Microbiome, Dietary Sugars, Acetates, Acetyl Coenzyme A, Acetate-CoA Ligase, Animals, ATP Citrate (pro-S)-Lyase, Fatty Acids, Fructose, Gene Expression Regulation, Isotope Labeling, Liver, Male, Substrate Specificity, Citric Acid, Hepatocytes, Lipogenesis, Mice
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