Xylitol is associated with the risk of serious cardiovascular events

MONDAY, June 17, 2024 (HealthDay News) — According to a study published online June 6 in the European Heart Journal.

Marco Witkowski, MD, of the Lerner Research Institute at the Cleveland Clinic, and colleagues conducted untargeted metabolomics studies on overnight fasting plasma samples in a discovery cohort of 1,157 sequentially stable patients undergoing elective diagnostic cardiac examinations. Subsequent analyses using isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS) were performed on an independent validation cohort of 2,149 participants. The effect of xylitol on platelet response and thrombus formation in vivo was investigated in complementary studies using isolated human platelets, platelet-rich plasma, whole blood, and animal models. Finally, the effects of xylitol consumption on platelet function were investigated in 10 healthy volunteers.

The researchers found that circulating concentrations of a polyol, tentatively named xylitol, were associated with the risk of MACE events in the first untargeted metabolomics study (discovery cohort). The association between xylitol and the risk of MACE events was confirmed in stable isotope dilution LC-MS/MS analyses (third versus first tertile-adjusted hazard ratio, 1.57). In complementary mechanistic studies, xylitol improved several indices of platelet reactivity and thrombosis formation in vivo at concentrations observed in fasting plasma. Xylitol-sweetened beverages significantly increased plasma concentrations and improved several functional measures of platelet reactivity in all subjects in intervention studies.

“Our studies suggest that xylitol likely carries an increased risk of thrombosis in the same vulnerable patients for whom it is marketed and intended to protect,” the authors write.

Several authors reported ties to the biopharmaceutical industry; several authors are named as co-inventors of filed and granted patents in the field of cardiovascular diagnostics and therapy.

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