血浆乳酸作为代谢健康的标志物：代谢综合征中乳酸升高对有氧代谢损伤的影响。
Plasma lactate as a marker of metabolic health: Implications of elevated lactate for impairment of aerobic metabolism in the metabolic syndrome.
机构信息
Department of Physical Therapy, East Carolina University, Greenville, NC.
Department of Surgery, East Carolina University, Greenville, NC.
出版信息
Surgery. 2019 Nov;166(5):861-866. doi: 10.1016/j.surg.2019.04.017. Epub 2019 Jun 25.
BACKGROUND
Fasting lactate is elevated in metabolic diseases and could possibly be predictive of the risk of developing the metabolic syndrome.
METHODS
Plasma samples were analyzed for fasting lactate to compare lean subjects, nondiabetic subjects with severe obesity, and metabolically impaired subjects. Subjects with severe obesity were studied 1 week before and 1 week to 9 months after gastric bypass surgery. Subjects with components of the metabolic syndrome were studied before and after 6 months of an exercise intervention.
RESULTS
Metabolically impaired subjects had higher fasting lactate concentrations (P < .0001) and respond to a glucose or insulin challenge with higher lactates than non-obese subjects (P < .004). Lactate was significantly reduced a week after gastric bypass surgery (P < .05) and further reduced 1 to 9 months after surgery (0.95 ± 0.04 mM in non-obese, 1.26 ± 0.12 mM in subjects with severe obesity, and 0.68 ± 0.03 mM 1-3 months after gastric bypass). Six months of chronic exercise resulted in a 16% reduction (P = .028) in fasting lactate.
CONCLUSION
Fasting plasma lactate was elevated in obese subjects with the metabolic syndrome compared with healthy lean individuals. Lactate was reduced by exercise and bariatric surgery, interventions that improve metabolic health and risk for subsequent disease. The results of this study and those previously published by our research group suggest that elevated lactate may be caused by an impairment in aerobic metabolism and may offer a metric assessing the severity of the metabolic syndrome.
背景
空腹血乳酸在代谢性疾病中升高，并且可能预测代谢综合征发生的风险。
方法
分析血浆样本中的空腹血乳酸，以比较瘦素患者、非糖尿病肥胖患者和代谢受损患者。对严重肥胖的患者进行研究，分别在胃旁路手术前一周、手术后一周至九个月进行研究。对患有代谢综合征组成部分的患者进行研究，分别在六个月的运动干预前后进行研究。
结果
代谢受损患者的空腹血乳酸浓度更高（P<0.0001），并且对葡萄糖或胰岛素刺激的反应也更高（P<0.004）。胃旁路手术后一周，血乳酸显著降低（P<0.05），手术后 1 至 9 个月进一步降低（非肥胖患者为 0.95±0.04 mM，严重肥胖患者为 1.26±0.12 mM，胃旁路手术后 1-3 个月为 0.68±0.03 mM）。六个月的慢性运动导致空腹血乳酸降低 16%（P=0.028）。
结论
与健康瘦素个体相比，患有代谢综合征的肥胖患者的空腹血乳酸升高。运动和减肥手术降低了乳酸，这些干预措施改善了代谢健康并降低了随后疾病的风险。本研究的结果和我们研究小组之前发表的结果表明，升高的乳酸可能是由于有氧代谢受损引起的，并且可能提供一种评估代谢综合征严重程度的指标。
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