Sugars and Adrenomedullary Proliferative Lesions: The Effects of Lactose and Various Polyalcohols

Abstract

Various substances have been found that destabilize the adrenomedullary system and cause a shift from normal to abnormal function and from controlled to uncontrolled growth. Some of these substances belong to the category of the sugar alcohols and slowly digested carbohydrates. An effect on the adrenal medulla of rats has been documented for sorbitol, xylitol, lactitol, and lactose. In rats, the polyol-induced formation of adrenal tumors involves at least three factors: a high genetic susceptibility that predisposes to adrenomedullary proliferation, an intestinal hyperabsorption of calcium followed by a disturbance of the calcium homeostatic hormonal system, and a functional and proliferative responsiveness of the adrenal gland to such changes in calcium homeostasis. In humans, none of these conditions is fulfilled. The genetic susceptibility is apparently very low, as shown by the rare occurrence of pheochromocytomas. Polyols do not measurably affect calcium uptake and calcium homeostasis, and there is no known association between hypercalciuria or hypercalcemia and a higher risk for pheochromocytomas in humans.