Effect of Progressive Weight Loss on Lactate Metabolism: A Randomized Controlled Trial.


Journal Article

OBJECTIVE: Lactate is an intermediate of glucose metabolism that has been implicated in the pathogenesis of insulin resistance. This study evaluated the relationship between glucose kinetics and plasma lactate concentration ([LAC]) before and after manipulating insulin sensitivity by progressive weight loss. METHODS: Forty people with obesity (BMI = 37.9 ± 4.3 kg/m2 ) were randomized to weight maintenance (n = 14) or weight loss (n = 19). Subjects were studied before and after 6 months of weight maintenance and before and after 5%, 11%, and 16% weight loss. A hyperinsulinemic-euglycemic clamp procedure in conjunction with [6,6-2 H2 ]glucose tracer infusion was used to assess glucose kinetics. RESULTS: At baseline, fasting [LAC] correlated positively with endogenous glucose production rate (r = 0.532; P = 0.001) and negatively with insulin sensitivity, assessed as the insulin-stimulated glucose disposal (r = -0.361; P = 0.04). Progressive (5% through 16%) weight loss caused a progressive decrease in fasting [LAC], and the decrease in fasting [LAC] after 5% weight loss was correlated with the decrease in endogenous glucose production (r = 0.654; P = 0.002) and the increase in insulin sensitivity (r = -0.595; P = 0.007). CONCLUSIONS: This study demonstrates the interrelationships among weight loss, hepatic and muscle glucose kinetics, insulin sensitivity, and [LAC], and it suggests that [LAC] can serve as an additional biomarker of glucose-related insulin resistance.

Full Text

Duke Authors

Cited Authors

  • Chondronikola, M; Magkos, F; Yoshino, J; Okunade, AL; Patterson, BW; Muehlbauer, MJ; Newgard, CB; Klein, S

Published Date

  • April 2018

Published In

Volume / Issue

  • 26 / 4

Start / End Page

  • 683 - 688

PubMed ID

  • 29476613

Pubmed Central ID

  • 29476613

Electronic International Standard Serial Number (EISSN)

  • 1930-739X

Digital Object Identifier (DOI)

  • 10.1002/oby.22129


  • eng

Conference Location

  • United States