High fructose corn syrup, which some studies have linked to obesity, may also be harmful to the liver, according to Duke University Medical Center research.

"We found that increased consumption of high fructose corn syrup was associated with scarring in the liver, or fibrosis, among patients with non-alcoholic fatty liver disease (NAFLD)," said Manal Abdelmalek, MD, MPH, associate professor of medicine in the Division of Gastroenterology/Hepatology at Duke University Medical Center.

Her team of researchers at Duke, one of eight clinical centers in the Nonalcoholic Steatohepatitis Clinical Research Network, looked at 427 adults enrolled in the network. They analyzed dietary questionnaires collected within three months of the adults' liver biopsies to determine their high fructose corn syrup intake and its association with liver scarring.

The researchers found only 19 percent of adults with NAFLD reported no intake of fructose-containing beverages, while 52 percent consumed between one and six servings a week and 29 percent consumed fructose-containing beverages on a daily basis.

An increase in consumption of fructose appeared to be correlated to increased liver fibrosis in patients with NAFLD.

"We have identified an environmental risk factor that may contribute to the metabolic syndrome of insulin resistance and the complications of the metabolic syndrome, including liver injury," Abdelmalek said.

Research Abdelmalek published in the Journal of Hepatology in 2008 showed that, within a small subset of patients, high fructose corn syrup was associated with NAFLD. Her latest research, published online in Hepatology, goes one step further and links high fructose corn syrup to the progression of liver injury.

"Non-alcoholic fatty liver disease is present in 30 percent of adults in the United States," Abdelmalek said. "Although only a minority of patients progress to cirrhosis, such patients are at increased risk for liver failure, liver cancer, and the need for liver transplant," she explained.

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