title: Comprehensive review on lactate metabolism in human health.
abstract: Metabolic pathways involved in lactate metabolism are important to understand the physiological response to exercise and the pathogenesis of prevalent diseases such as diabetes and cancer. Monocarboxylate transporters are being investigated as potential targets for diagnosis and therapy of these and other disorders. Glucose and alanine produce pyruvate which is reduced to lactate by lactate dehydrogenase in the cytoplasm without oxygen consumption. Lactate removal takes place via its oxidation to pyruvate by lactate dehydrogenase. Pyruvate may be either oxidized to carbon dioxide producing energy or transformed into glucose. Pyruvate oxidation requires oxygen supply and the cooperation of pyruvate dehydrogenase, the tricarboxylic acid cycle, and the mitochondrial respiratory chain. Enzymes of the gluconeogenesis pathway sequentially convert pyruvate into glucose. Congenital or acquired deficiency on gluconeogenesis or pyruvate oxidation, including tissue hypoxia, may induce lactate accumulation. Both obese individuals and patients with diabetes show elevated plasma lactate concentration compared to healthy subjects, but there is no conclusive evidence of hyperlactatemia causing insulin resistance. Available evidence suggests an association between defective mitochondrial oxidative capacity in the pancreatic β-cells and diminished insulin secretion that may trigger the development of diabetes in patients already affected with insulin resistance. Several mutations in the mitochondrial DNA are associated with diabetes mellitus, although the pathogenesis remains unsettled. Mitochondrial DNA mutations have been detected in a number of human cancers. d-lactate is a lactate enantiomer normally formed during glycolysis. Excess d-lactate is generated in diabetes, particularly during diabetic ketoacidosis. d-lactic acidosis is typically associated with small bowel resection.
authors.affiliation: Nephrology Division, Hospital General Juan Cardona, Ave. Pardo Bazán, s/n, 15406 Ferrol, La Coruña, Spain. Electronic address: madevaa@yahoo.com.
authors.forename: M
authors.initials: M
authors.lastname: Adeva-Andany
authors.affiliation: Internal Medicine Division, Policlínica Assistens, c/Federico García, 4-planta baja, 15009 La Coruña, Spain.
authors.forename: M
authors.initials: M
authors.lastname: López-Ojén
authors.affiliation: Nephrology Division, Hospital General Juan Cardona, Ave. Pardo Bazán, s/n, 15406 Ferrol, La Coruña, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Funcasta-Calderón
authors.affiliation: Nephrology Division, Hospital General Juan Cardona, Ave. Pardo Bazán, s/n, 15406 Ferrol, La Coruña, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Ameneiros-Rodríguez
authors.affiliation: Nephrology Division, Hospital General Juan Cardona, Ave. Pardo Bazán, s/n, 15406 Ferrol, La Coruña, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Donapetry-García
authors.affiliation: Nephrology Division, Hospital General Juan Cardona, Ave. Pardo Bazán, s/n, 15406 Ferrol, La Coruña, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Vila-Altesor
authors.affiliation: Nephrology Division, Hospital General Juan Cardona, Ave. Pardo Bazán, s/n, 15406 Ferrol, La Coruña, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Rodríguez-Seijas
mesh_terms: D000409:Alanine / Q000378:metabolism; D002245:Carbon Dioxide / Q000378:metabolism; D003920:Diabetes Mellitus / Q000503:physiopathology; D005947:Glucose / Q000378:metabolism; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism*; D053858:Metabolic Networks and Pathways; D008928:Mitochondria / Q000378:metabolism*; D009369:Neoplasms / Q000503:physiopathology; D010084:Oxidation-Reduction; D010088:Oxidoreductases / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism; D019289:Pyruvic Acid / Q000378:metabolism
chemical_list: D002245:Carbon Dioxide; D019344:Lactic Acid; D019289:Pyruvic Acid; D010088:Oxidoreductases; D005947:Glucose; D000409:Alanine; D010100:Oxygen
keywords: Diabetes mellitus; Gluconeogenesis; Glycolysis; Insulin resistance; Respiratory chain; Tricarboxylic acid cycle