Fructose is also the only sugar known to increase serum uric levels.
Fructose induces uric acid production by increasing ATP degradation to
AMP, a uric acid precursor. Fructose phosphorylation in the liver uses
ATP and the accompanying phosphate depletion limits regeneration of
ATP fromADP,which in turn serves as a substrate for uric acid formation
[96]. The production of uric acid in the liver by xanthine oxidase may
reduce endothelial nitric oxide, which could partially mediate the
association between SSBs and CHD [97]. Hyperuricemia often precedes
the development of obesity, hyperinsulinemia and T2DM, and findings
from animal studies suggest that it may have a role in the development
ofMeySyn [21]. The prevalence of MetSyn has been shown to be as high
as 62% in individualswith gout [21]. Gout has been shown to exacerbate
formation of kidney stones and renal disease due to increases in serum
urate concentrations [21]. Phosphoric acid used primarily for acidifying
cola beverages may further increase development of kidney stones and
chronic kidney disease [67].