D-lactic acidemia and aciduria in pediatric and adult patients with short bowel syndrome.
D-Lactate produced by abundant intestinal lactobacilli during acidotic episodes in short bowel (SB) patients is commonly regarded as a main factor in the pathogenesis of SB syndrome-associated (D-lactic) acidosis. Since we had observed that gram-positive bacteria, mainly lactobacilli, were abundant even in the absence of acidosis, we studied serum concentrations and urinary excretions of D- and L-lactate in young and adult SB patients, especially during nonacidotic periods. Serum L-lactate and urinary L-lactate excretion were similar in adults and children. Serum D-lactate and urinary D-lactate excretion were higher in SB children than in SB adults. Food consumption affects D-lactate production and alters D-lactic acidemia and aciduria. We conclude that D-lactate is frequently present in serum of SB patients even in the absence of acidosis. High serum concentrations and urinary excretions may reflect dietary factors in these patients.
Bongaerts
G
G
Department of Medical Microbiology, University Hospital Nijmegen St. Radboud, The Netherlands.
Tolboom
J
J
Naber
T
T
Bakkeren
J
J
Severijnen
R
R
Willems
H
H
D000140:Acidosis, Lactic / Q000209:etiology* / Q000378:metabolism; D000328:Adult; D002675:Child, Preschool; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D007223:Infant; D007773:Lactates / Q000097:blood* / Q000652:urine*; D019344:Lactic Acid; D008137:Longitudinal Studies; D008297:Male; D012016:Reference Values; D012778:Short Bowel Syndrome / Q000150:complications* / Q000378:metabolism
D007773:Lactates; D019344:Lactic Acid