---
title: "Cleveland Clinic Erythritol Study: Endogenous Pentose Pathway vs Postprandial Spikes (Cleveland Clinic Polyol Plaque Audit) | Nutrition Research Labs"
source_url: "https://nutritionresearchlabs.com/studies/erythritol-xylitol-platelet-thrombosis-cleveland-clinic-study"
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description: "Clinical audit of Cleveland Clinic Polyol Plaque (PMID: 36849732, 4,173 cardiac patient cohort + 8 healthy human volunteers): Patients in the top quartile of ci"
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> **Canonical Source:** [https://nutritionresearchlabs.com/studies/erythritol-xylitol-platelet-thrombosis-cleveland-clinic-study](https://nutritionresearchlabs.com/studies/erythritol-xylitol-platelet-thrombosis-cleveland-clinic-study)
>
> *Clinical audit of Cleveland Clinic Polyol Plaque (PMID: 36849732, 4,173 cardiac patient cohort + 8 healthy human volunteers): Patients in the top quartile of ci*

## Media Hype vs. Absolute Clinical Reality (Information Gain Audit)

- **Viral Headline Claim:**
- **True Placebo-Adjusted Absolute Outcome:** Patients in the top quartile of circulating plasma erythritol experienced an adjusted Hazard Ratio of 1.80 to 2.21 for Major Adverse Cardiovascular Events (MACE). Ex vivo addition of erythritol heightened platelet reactivity.
- **Relative vs. Absolute Statistical Breakdown:** Crucially, the human body synthesizes erythritol endogenously from glucose via the pentose phosphate pathway in response to hyperglycemia and oxidative stress. Patients with pre-existing metabolic disease produce higher baseline erythritol, introducing severe reverse-causality confounding that media reports ignored.
- **Funding & Sponsor Audit:** National Institutes of Health (NIH) & American Heart Association (Independent Academic / NIH)
- **Human Equivalent Dosing Protocol:** Observational trial; acute challenge used single 30g oral ingestion dissolved in water.

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