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


ABSTRACT: 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.

SUBMITTER: Chondronikola M 

PROVIDER: S-EPMC5866193 | BioStudies | 2018-01-01

REPOSITORIES: biostudies

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