Article Impact Level: HIGH Data Quality: STRONG Summary of European Heart Journal, ehae244. https://doi.org/10.1093/eurheartj/ehae244 Dr. Marco Witkowski et al.
Points
- The research investigated the impact of xylitol, a low-calorie sugar alcohol, on cardiovascular health outcomes, particularly major adverse cardiovascular events (MACE).
- The study used untargeted metabolomics on fasting plasma samples from 1157 subjects. It validated the findings with LC-MS/MS analyses on a cohort of 2149 individuals, along with human platelet studies, whole blood analyses, and animal model experiments.
- Initial metabolomics studies found an association between circulating xylitol levels and the risk of MACE over three years, confirmed by subsequent LC-MS/MS analyses.
- Mechanistic studies showed that xylitol increased platelet reactivity and thrombosis potential in vivo, aligning with elevated plasma levels after xylitol consumption in an intervention study with ten healthy volunteers.
- The findings suggest potential cardiovascular risks linked to xylitol consumption, highlighting the need for further research to evaluate its safety profile in cardiovascular health.
Summary
Understanding the residual risks contributing to cardiovascular diseases remains a critical area of research. Low-calorie sweeteners, commonly used as sugar substitutes in processed foods, are perceived to offer health advantages. Sugar alcohols are noteworthy among these sweeteners, as they are also endogenously produced, albeit at significantly lower levels compared to their consumption as substitutes. This study aimed to investigate the metabolic pathways and potential impact of xylitol, a polyol sugar alcohol, on cardiovascular health outcomes, particularly major adverse cardiovascular events (MACE).
The research employed untargeted metabolomics analyses on fasting plasma samples from a discovery cohort of 1157 stable subjects undergoing cardiac evaluations. Subsequent stable isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyses were conducted on a validation cohort of 2149 individuals. Additionally, human platelet studies, whole blood analyses, and animal model experiments were carried out to assess the effects of xylitol on platelet reactivity and thrombus formation in vivo. An intervention study involving ten healthy volunteers consuming a xylitol-sweetened drink was also conducted to evaluate its impact on platelet function.
The initial metabolomics studies in the discovery cohort revealed an association between circulating levels of xylitol and the risk of incident MACE over a 3-year period. Subsequent LC-MS/MS analyses in the validation cohort confirmed this association, with specific emphasis on xylitol and its relationship to MACE risk. Mechanistic studies demonstrated that xylitol heightened platelet reactivity and thrombosis potential in vivo, consistent with the elevated plasma levels observed post-consumption in the intervention study. These findings underscore the potential cardiovascular risks associated with xylitol consumption and emphasize the need for further investigations to evaluate its safety profile in relation to cardiovascular health.
Link to the article: https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehae244/7683453
References Witkowski, M., Nemet, I., Li, X. S., Wilcox, J., Ferrell, M., Alamri, H., Gupta, N., Wang, Z., Tang, W. H. W., & Hazen, S. L. (2024). Xylitol is prothrombotic and associated with cardiovascular risk. European Heart Journal, ehae244. https://doi.org/10.1093/eurheartj/ehae244
