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1.
Oral lactate slows gastric emptying and suppresses appetite in young males.
Pedersen, MGB, Søndergaard, E, Nielsen, CB, Johannsen, M, Gormsen, LC, Møller, N, Jessen, N, Rittig, N
Clinical nutrition (Edinburgh, Scotland). 2022;(2):517-525
Abstract
BACKGROUND Lactate serves as an alternative energy fuel but is also an important signaling metabolite. We aimed to investigate whether oral lactate administration affects appetite-regulating hormones, slows gastric emptying rate, and dampens appetite. METHODS Ten healthy male volunteers were investigated on two separate occasions: 1) following oral ingestion of D/L-Na-lactate and 2) following oral ingestion of isotonic iso-voluminous NaCl and intravenous iso-lactemic D/L-Na-lactate infusions. Appetite was evaluated by questionnaires and ad libitum meal tests were performed at the end of each study day. Gastric emptying rate was evaluated using the acetaminophen test. RESULTS Plasma concentrations of growth differential factor 15 (GDF15, primary outcome) increased following oral and iv administration of lactate (p < 0.001) with no detectable difference between interventions (p = 0.15). Oral lactate administration lowered plasma concentrations of acylated ghrelin (p = 0.02) and elevated glucagon like peptide-1 (GLP-1, p = 0.045), insulin (p < 0.001), and glucagon (p < 0.001) compared with iv administration. Oral lactate administration slowed gastric emptying (p < 0.001), increased the feeling of being "full" (p = 0.008) and lowered the "anticipated future food intake" (p = 0.007) compared with iv administration. Food intake during the ad libitum meal test did not differ between the two study days. CONCLUSION Oral lactate administration has a direct effect on the upper gastrointestinal tract, affecting gut hormone secretion, motility and appetite sensations which cannot be mediated through lactate in the systemic circulation alone. These data suggest that compounds rich in lactate may be useful in the treatment of metabolic disease. CLINICAL TRIAL REGISTRY NUMBER NCT0429981, https://clinicaltrials.gov/ct2/show/NCT04299815.
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2.
Effect of sodium-chloride ion difference on pH regulation.
Nozawa, H, Tsuboi, N, Nariai, R, Nishimura, N, Nakagawa, S
Clinical biochemistry. 2021;:75-77
Abstract
BACKGROUND In the Stewart approach, the difference between the cation and anion concentrations, especially between sodium, accounting for the majority of cations, and chloride, comprising the majority of anions, is an important factor in pH regulation. This study investigated the effect of sodium-chloride ion difference (SCD) on pH regulation comparing with those of PaCO2 and lactate. METHODS Arterial blood gas samples measured at our pediatric intensive care unit of a tertiary children's hospital between January and June 2020 were included. Samples that met the following criteria were excluded: samples collected from patients taking potassium bromide and samples with lactate concentration of >25 mmol/L. From the eligible data, pH was chosen as the dependent variable and SCD, lactate, and PaCO2 as independent variables, and then, a multiple regression analysis was performed. RESULTS In total, 5360 samples were included. Of these, five samples were excluded according to the exclusion criteria. Finally, 5355 samples were analyzed. As the variance inflation factors were <2.0 for all three variables, there was no multicollinearity. The following model was derived: pH = 7.384 + [0.97 × SCD (mEq/L) - 0.66 × PaCO2 (mmHg) - 1.33 × Lac (mmol/L)] × 10-2 (adjusted R-squared = 0.73; P value < 0.001). Based on the standardized partial regression coefficients (β), pH was affected in the order of PaCO2 (βPaCO2 = -0.95), SCD (βSCD = 0.72), and lactate (βlactate = -0.33). CONCLUSIONS The prevention of SCD reduction, together with respiratory and metabolic management, is important for pH regulation.
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3.
Lactate Threshold Training Program on Patients with Multiple Sclerosis: A Multidisciplinary Approach.
Amato, A, Ragonese, P, Ingoglia, S, Schiera, G, Schirò, G, Di Liegro, CM, Salemi, G, Di Liegro, I, Proia, P
Nutrients. 2021;(12)
Abstract
Physical activity could play a key role in improving the quality of life, particularly in patients with nervous system diseases such as multiple sclerosis (MS). Through lactacid anaerobic training, this study aims to investigate the effects at a bio-psycho-physical level to counteract the chronic fatigue associated with the pathology, and to improve mental health at a psychological and neurotrophic level. Eight subjects (age: 34.88 ± 4.45 years) affected by multiple sclerosis were involved. A lactate threshold training program was administered biweekly for 12 weeks at the beginning of the study (T0), at the end of the study (T1) and at 9 months after the end of the study (T2), with physical, psychological and hematochemicals parameters, and dietary habits being tested. The results obtained confirmed that lactacid exercise can influence brain-derived neurotrophic factor (BDNF) levels as well as dehydroepiandrosterone sulfate (DHEAS) levels. In addition, levels of baseline lactate, which could be best used as an energy substrate, showed a decrease after the protocol training. Self-efficacy regarding worries and concerns management significantly increased from T0 to T1. The eating attitudes test (EAT-26) did not highlight any eating disease in the patients with a normal diet enrolled in our study. Physical exercise also greatly influenced the patients psychologically and emotionally, increasing their self-esteem. Lactate threshold training, together with dietary habits, appears to exert synergic positive effects on inflammation, neural plasticity and neuroprotection, producing preventive effects on MS symptoms and progression.
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4.
Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit.
Liu, J, Yan, H, Li, Y
BMC endocrine disorders. 2021;(1):110
Abstract
BACKGROUND Children with diabetic ketoacidosis often have elevated lactate. In this study, we investigated the clinical variables associated with hyperlactatemia in children with diabetic ketoacidosis. METHODS We designed a single-center retrospective descriptive study of children with diabetic ketoacidosis in a pediatric intensive care unit. RESULTS Of the 107 patients with diabetic ketoacidosis included in the analysis, 61 developed hyperlactatemia. Multivariate logistic regression analysis showed that heart rate (p = 0.003),diastolic blood pressure (p = 0.001) and stage of severity (p = 0.042) were independently associated with the development of hyperlactatemia in diabetic ketoacidosis. We found that lactate level was not significantly associated with length of hospital stay (p = 0.115) or the length of time to diabetic ketoacidosis resolution (p = 0.143). CONCLUSIONS Children with diabetic ketoacidosis presenting with severer stage, elevated heart rate and higher diastolic blood pressure may be prone to hyperlactatemia. Hyperlactatemia was not associated with length of time to DKA resolution and length of hospital stay.
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5.
Higher Postdialysis Lactic Acid Is Associated with Postdialysis Fatigue in Maintenance of Hemodialysis Patients.
Zu, Y, Lu, X, Yu, Q, Yu, L, Li, H, Wang, S
Blood purification. 2020;(5):535-541
Abstract
BACKGROUND Postdialysis fatigue (PDF) is not an unusual symptom among hemodialysis (HD) patients; however, its causes remain unclear. The aim of this study was to analyze the factors responsible for PDF in maintenance HD patients. METHODS This was a single-center cross-sectional study conducted between March 2018 and March 2019 at the Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University. One hundred and fifteen HD patients were enrolled. Clinical data on demographics, comorbidities, and the primary cause of end-stage renal disease were obtained by questionnaires. Laboratory data were collected pre- and post-HD. Participants were divided into 3 groups according to PDF degree. RESULTS The prevalence of PDF in participants was 60% (n = 69); 26.09% had mild PDF; and 33.91% had severe PDF. In the severe PDF group, the prevalence of intradialytic hypotension (IDH) was 38.46%, significantly higher than in the no PDF group (no-PDF; 8.70%) and mild-PDF (16.67%; p = 0.01 for both) groups. In the severe-PDF group, Charlson comorbidity index score and ultrafiltration rate were significantly higher than those in the no-PDF group (p = 0.040, p = 0.020, respectively). In the severe-PDF group, postdialysis lactic acid (Lac) level was significantly higher than that in the no-PDF or mild-PDF groups (p = 0.013 for both). And in the severe-PDF group, postdialysis sodium (Na) was significantly lower than that in the no-PDF or mild-PDF groups (p = 0.026 for both). It was shown by unconditional logistic regression analysis that IDH occurrence (OR 3.821, 95% CI 1.330-10.975), ultrafiltration rates (OR 1.142, 95% CI 1.018-1.281), lower postdialysis Na level (OR 0.724, 95% CI 0.556-0.942), and higher postdialysis Lac level (OR 2.465, 95% CI 1.126-5.397) were associated with PDF (p = 0.013, p = 0.024, p = 0.016, and p = 0.024, respectively). CONCLUSIONS The prevalence of PDF was high among our study participants. PDF incidence was correlated with the IDH occurrence and higher postdialysis Lac and lower postdialysis Na levels. The level of Lac was a significant influencing factor for the fatigue of patients. More attention should thus be paid to PDF.
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Change in plasma lactate concentration during arctigenin administration in a phase I clinical trial in patients with gemcitabine-refractory pancreatic cancer.
Fujioka, R, Mochizuki, N, Ikeda, M, Sato, A, Nomura, S, Owada, S, Yomoda, S, Tsuchihara, K, Kishino, S, Esumi, H
PloS one. 2018;(6):e0198219
Abstract
Arctigenin is evaluated for antitumor efficacy in patients with pancreatic cancer. It has an inhibitory activity on mitochondrial complex I.Therefore, plasma lactate level of patients after arctigenin administration was evaluated for biomarker of clinical response and/or adverse effect. Plasma lactate level in 15 patients enrolled in a Phase I clinical trial of GBS-01 rich in arctigenin was analyzed by colorimetric assay. Statistical analyses for association of plasma lactate and clinical responses, pharmacokinetics of arctigenin, and background factors of each patient by multivariate and univariate analyses.In about half of the patients, transient increase of lactate was observed. Correlation between plasma lactate level and pharmacokinetic parameters of arctigenin and its glucuronide conjugate, and clinical outcome was not detected. Regarding to the determinant of lactate level, only slight association with liver function test was detected. Plasma lactate level is primary determined by reutilization rather than production for antitumor effect and dose not serve as a biomarker. Arctigenin, inhibition of mitochondrial complex I, plasma lactate concentration, phase I clinical trial of GBS-01, Cori cycle.
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Effects of drop set resistance training on acute stress indicators and long-term muscle hypertrophy and strength.
Fink, J, Schoenfeld, BJ, Kikuchi, N, Nakazato, K
The Journal of sports medicine and physical fitness. 2018;(5):597-605
Abstract
BACKGROUND We investigated the effects of 2 different resistance training (RT) protocols on muscle hypertrophy and strength. The first group (N.=8) performed a single drop set (DS) and the second group (N.=8) performed 3 sets of conventional RT (normal set, NS). METHODS Eight young men in each group completed 6 weeks of RT. Muscle hypertrophy was assessed via magnetic resonance imaging (MRI) and strength via 12 repetition maximum tests before and after the 6 weeks. Acute stress markers such as muscle thickness (MT), blood lactate (BL), maximal voluntary contraction (MVC), heart rate (HR) and rating of perceived exertion (RPE) have been measured before and after one bout of RT. RESULTS Both groups showed significant increases in triceps muscle cross-sectional area (CSA) (10.0±3.7%, effect size (ES) =0.47 for DS and 5.1±2.1%, ES=0.25 for NS). Strength increased in both groups (16.1±12.1%, ES=0.88 for DS and 25.2±17.5%, ES=1.34 for NS). Acute pre/post measurements for one bout of RT showed significant changes in MT (18.3±5.8%, P<0.001) and MVC (-13.3±7.1, P<0.05) in the DS group only and a significant difference (P<0.01) in RPE was observed between groups (7.7±1.5 for DS and 5.3±1.4 for NS). CONCLUSIONS Superior muscle gains might be achieved with a single set of DS compared to 3 sets of conventional RT, probably due to higher stress experienced in the DS protocol.
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8.
Effects of a new bicarbonate/lactate-buffered neutral peritoneal dialysis fluid for peritoneal failure in patients undergoing peritoneal dialysis.
Hoshino, T, Ishii, H, Kitano, T, Shindo, M, Miyazawa, H, Yamada, H, Ito, K, Ueda, Y, Kaku, Y, Hirai, K, et al
Discovery medicine. 2016;(114):81-8
Abstract
BACKGROUND The highly concentrated lactate in peritoneal dialysis fluid (PDF) has been considered to contribute to peritoneal failure in patients undergoing PD. A new PDF containing a lower lactate concentration, physiological bicarbonate concentration, and neutral pH (bicarbonate/lactate-buffered neutral PDF) was recently developed. We compared the clinical effects of this bicarbonate/lactate-buffered neutral PDF and a lactate-buffered neutral PDF. METHODS AND DESIGN Patients undergoing PD were changed from a lactate-buffered neutral PDF to a bicarbonate/lactate-buffered neutral PDF. We then investigated the changes in peritoneal functions as estimated by a peritoneal equilibration test (PET) and the following surrogate markers of peritoneal membrane failure in the drained dialysate: fibrin degradation products (FDP), vascular endothelial growth factor (VEGF), cancer antigen 125 (CA125), interleukin-6 (IL-6), and transforming growth factor beta 1 (TGF-β1). RESULTS Fourteen patients undergoing PD were enrolled. The PET results were not different before and after use of the bicarbonate/lactate-buffered neutral PDF. The FDP concentration significantly decreased from 15.60 ± 13.90 to 6.04 ± 3.49 μg/mL (p = 0.02) and the VEGF concentration significantly decreased from 37.83 ± 15.82 to 27.70 ± 3.80 pg/mL (p = 0.02), while the CA125 and IL-6 concentrations remained unchanged before and after use of the bicarbonate/lactate-buffered neutral PDF. TGF-β1 was not detected in most patients. CONCLUSION The bicarbonate/lactate-buffered neutral PDF decreased the FDP and VEGF concentrations in the drained dialysate. These results suggest that the decreased lactate level achieved by administration of bicarbonate with a neutral pH in PDF may contribute to decreased peritoneal membrane failure in patients undergoing PD.
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9.
Effect of vitamin A administration on free radicals and lactate levels in individuals exercised to exhaustion.
Patlar, S, Baltaci, AK, Mogulkoc, R
Pakistan journal of pharmaceutical sciences. 2016;(5):1531-1534
Abstract
This study was performed to explore the effect of vitamin A administration on Free Radicals production and antioxidant system activity and lactate levels in individuals exercised to exhaustion The study registered 10 healthy sedentary males their mean age was 22,85±0,26 years. The subjects were orally administrated with 300 mg vitamin A (retinol) for 4 weeks and engaged in strenuous exercise (using the Bruce protocol) once a week. Blood samples were collected from the subjects at four different times, before and after the supplementation and before and after exercise to analyze Malondialdehyde (MDA), Nitric oxide (NO), Glutathione (GSH), Glutathione peroxidase (GSH-Px), Catalase (CAT), Superoxide dismutase (SOD) levels using colorimetric ELISA test kits and plasma lactate levels using an autoanalyzer. Exhaustion exercise leaded to an increase in both MDA, NO, and lactate, and GSH, GSH-Px, CAT and SOD levels compared to resting levels both before and after supplementation (p<0.05). Increased NO levels found in pre-supplementation exhaustion showed a significant decrease after the supplementation of vitamin A (p<0.05), but the other parameters were not changed after vitamin A administration. The results of our study demonstrate that the increase caused by 4-week strenuous exercise in the levels of the free radical NO was offset by vitamin A supplementation. It can be suggested that supplementation of vitamin A at physiological doses has a limited effect on lipid peroxidation caused by strenuous exercise.
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10.
Improvement of Neuroenergetics by Hypertonic Lactate Therapy in Patients with Traumatic Brain Injury Is Dependent on Baseline Cerebral Lactate/Pyruvate Ratio.
Quintard, H, Patet, C, Zerlauth, JB, Suys, T, Bouzat, P, Pellerin, L, Meuli, R, Magistretti, PJ, Oddo, M
Journal of neurotrauma. 2016;(7):681-7
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Abstract
Energy dysfunction is associated with worse prognosis after traumatic brain injury (TBI). Recent data suggest that hypertonic sodium lactate infusion (HL) improves energy metabolism after TBI. Here, we specifically examined whether the efficacy of HL (3h infusion, 30-40 μmol/kg/min) in improving brain energetics (using cerebral microdialysis [CMD] glucose as a main therapeutic end-point) was dependent on baseline cerebral metabolic state (assessed by CMD lactate/pyruvate ratio [LPR]) and cerebral blood flow (CBF, measured with perfusion computed tomography [PCT]). Using a prospective cohort of 24 severe TBI patients, we found CMD glucose increase during HL was significant only in the subgroup of patients with elevated CMD LPR >25 (n = 13; +0.13 [95% confidence interval (CI) 0.08-0.19] mmol/L, p < 0.001; vs. +0.04 [-0.05-0.13] in those with normal LPR, p = 0.33, mixed-effects model). In contrast, CMD glucose increase was independent from baseline CBF (coefficient +0.13 [0.04-0.21] mmol/L when global CBF was <32.5 mL/100 g/min vs. +0.09 [0.04-0.14] mmol/L at normal CBF, both p < 0.005) and systemic glucose. Our data suggest that improvement of brain energetics upon HL seems predominantly dependent on baseline cerebral metabolic state and support the concept that CMD LPR - rather than CBF - could be used as a diagnostic indication for systemic lactate supplementation following TBI.