title: Association of lactate with blood pressure before and after rapid weight loss.
abstract: BACKGROUND
  The mechanism linking obesity with its downstream complications is poorly understood. Accumulating evidence suggests that insufficient oxidative capacity plays a central role in the development of insulin resistance and, perhaps, hypertension.
  
  
  METHODS
  To investigate this hypothesis, we measured lactate, a marker of the gap between energy expenditure and oxidative capacity, in 40 obese subjects with the metabolic syndrome (Ob-MS), 40 obese subjects without the metabolic syndrome (Ob), and 20 lean controls (LCs). The 40 Ob-MS participants were then entered into a 12-20 week very low-calorie diet (VLCD) intervention. The change in lactate and a number of other metabolic factors including blood pressure were subsequently assessed.
  
  
  RESULTS
  At baseline, median lactate levels were significantly higher in both the Ob (36.4 mg/dl) and Ob-MS (34.7 mg/dl) groups when compared to LCs (17.4 mg/dl; P < 0.001). After the VLCD intervention, Ob-MS subjects lost 14.7 kg on average, corresponding to a 5.0 kg/m(2) decrease in body mass index (BMI). Lactate levels fell from 41.3 to 28.7 mg/dl, a 31% reduction (P = 0.006). Even after adjustment for BMI change, change in lactate was strongly associated with change in diastolic blood pressure (DBP) (P = 0.007) and mean arterial pressure (P = 0.014), but not with systolic blood pressure (SBP) (P = 0.20) or other obesity-related traits.
  
  
  CONCLUSIONS
  Baseline and longitudinal associations between lactate and DBP suggest that insufficient oxidative capacity may play a role in obesity-related hypertension.
authors.affiliation: Department of Epidemiology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Stephen O
authors.initials: SO
authors.lastname: Crawford
authors.forename: Marietta S
authors.initials: MS
authors.lastname: Ambrose
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Brancati
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.forename: J Hunter
authors.initials: JH
authors.lastname: Young
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D016022:Case-Control Studies; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000178:diet therapy / Q000378:metabolism / Q000503:physiopathology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology*; D012189:Retrospective Studies; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D019344:Lactic Acid