Metabolic investigations during xylitol infusion

The excretion of urinary acidic metabolites by 10 patients undergoing gastric or biliary tract surgery has been studied. Five patients were infused with xylitol and 5 with glucose. Four of the xylitol-infused patients had hyperglycollic aciduria and 3 of the glucose-infused patients had hyperlactic aciduria. There was no hyperoxaluria. Four of the xylitol-infused patients excreted more tetronic acids than any of the glucose-infused patients. Threonic acid was the predominant tetronic acid excreted by most (4/5) of the xylitol-infused subjects. Erythronic acid predominated in the glucose-infused as in control ambulant non-hospitalised subjects. It is suggested that these changes point to overloading of the transketolase pathway during xylitol infusion.