title: Kinetic enzymic assay for D(-)-lactate, with use of a centrifugal analyzer.
abstract: The D(-) isomer of lactic acid appears to cause a form of metabolic encephalopathy experienced by patients who have had jejunoileal bypass for morbid obesity. However, analysis for D(-)-lactate is not routinely available in clinical or reference laboratories. We describe an enzymic centrifugal-analyzer assay for D(-)-lactate in plasma or serum, with use of D(-)-lactate dehydrogenase. The method involves two-point kinetic calibration and preincubation of specimen and NAD+, thus eliminating the need for specimen-blanking or protein-precipitating pretreatment. This rapid, accurate, and precise assay should be helpful in evaluating patients with "short-bowel syndrome" who display confusion, lethargy, ataxia, or other central nervous-system disturbances that may be ascribable to D(-)-lactic acidosis.
mesh_terms: D000138:Acidosis / Q000097:blood*; D001322:Autoanalysis; D005260:Female; D006801:Humans; D007700:Kinetics; D007770:L-Lactate Dehydrogenase; D007773:Lactates / Q000032:analysis / Q000097:blood*; D008875:Middle Aged; D009243:NAD; D013223:Statistics as Topic; D013237:Stereoisomerism; D014461:Ultracentrifugation
chemical_list: D007773:Lactates; D009243:NAD; D007770:L-Lactate Dehydrogenase