BIOCHEMICAL AND CLINICAL EFFECTS OF ASPARTAME IN PATIENTS WITH CHRONIC, STABLE ALCOHOLIC LIVER-DISEASE

Aspartame is an artificial sweetener completely metabolized in the gut and absorbed as aspartate, phenylalanine, and methanol. Phenylalanine is thought to mediate or exacerbate hepatic encephalopathy, and an im paired liver may not be able to cope with the ammoniagenic properties of the amino acid constituents, or adequately metabolize methanol. Thu s, we compared the clinical and biochemical effects of a single ingest ion of aspartame (15 mg/kg) to skim milk (phenylalanine content equimo lar to aspartame) and placebo in patients with chronic, alcoholic live r disease in a randomized, crossover study. Aspartame produced an elev ation of plasma phenylalanine significantly greater than milk and plac ebo (C(max) 14.55 +/- 7.38, 10.95 +/- 4.95, 8.84 +/-4.55 mumol/dl, res pectively; p < 0.01). However, quantified encephalopathic changes were observed only with milk (p < 0.05). Plasma aspartate, methanol, forma te, and ammonia levels remained unchanged after all treatments. The la ck of clinical derangements in encephalopathic indices, methanol accum ulation, or biochemical changes in liver status suggests that a single large dose of aspartame (representing 5 times the average daily intak e of adults) may be used safely by patients with chronic, stable liver disease.