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Updated: Mar 28, 2026
Mapping Metabolism: Monitoring Lactate Dehydrogenase Activity Directly in Tissue
Published on: June 21, 2018
Cross-Sectional Association Between Normal-Range Lactate Dehydrogenase, Physical Activity and Cardiovascular Disease
Samuel L Buckner1, Jeremy P Loenneke1, Paul D Loprinzi2
1Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA.
Insights
Increased physical activity is linked to higher normal-range lactate dehydrogenase (LDH) levels. These normal LDH levels, in turn, are associated with a reduced risk of cardiovascular disease (CVD).
Area of Science:
- Biomarkers and Disease Risk Assessment
- Exercise Physiology and Cardiovascular Health
Background:
- Lactate dehydrogenase (LDH) traditionally indicates negative health outcomes.
- Emerging evidence suggests normal LDH levels may inversely correlate with coronary heart disease.
- The relationship between physical activity, normal LDH, and cardiovascular disease (CVD) risk requires further investigation.
Purpose of the Study:
- To investigate the association between physical activity and normal-range LDH levels.
- To examine how normal-range LDH levels relate to the predicted risk of atherosclerotic cardiovascular disease (ASCVD).
Main Methods:
- Utilized data from 2087 adults (aged 40-79) in the 2003-2006 National Health and Nutrition Examination Survey (NHANES).
- Included participants with normal LDH levels (105-333 IU/L) measured from blood samples.
- Assessed physical activity via accelerometry (total minutes per day and total activity count per day) and calculated 10-year ASCVD risk using Pooled Cohort Equations.
Main Results:
- A 1-standard-deviation increase in total physical activity (TPA) was associated with a 30% increased odds of being in the highest LDH quartile (LDH quartile 4).
- Participants in the highest LDH quartile (quartile 4) had 55% reduced odds of being in the highest ASCVD risk quartile (quartile 4).
Conclusions:
- Normal-range LDH levels may serve as a novel biomarker linking physical activity to reduced CVD risk.
- Findings support the diagnostic value of monitoring normal LDH levels in relation to lifestyle factors and cardiovascular health.
Introduction:
Lactate dehydrogenase (LDH) has historically been used as an indicator of negative health outcomes, such as myocardial ischaemia and lung disease; however, recent evidence has suggested that LDH levels within normal limits may be inversely related to coronary heart disease. Therefore, the purpose of the current study was to examine the association between physical activity and normal-range LDH levels, and how LDH levels, in turn, are associated with the predicted risk of cardiovascular disease (CVD).
Methods:
Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were used (N = 2087 adults aged 40-79 years; analysed in 2015). Participants were included if they had LDH levels within the normal range (105-333 IU/L). LDH values were obtained from a blood sample. Physical activity was measured using accelerometry and expressed in total minutes per day (TPA), as well as in the total activity count per day (TAC/d). Finally, the predicted 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was calculated using validated Pooled Cohort Equations.
Results:
In a polytomous logistic regression, for a 1-standard-deviation (1SD) increase in TPA (SD 102.3 min/day), the participants were at 30% increased odds (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.11-1.52, P = 0.002) of being in LDH quartile 4 (versus quartile 1). Those in LDH quartile 4 (versus quartile 1) were at 55% reduced odds (OR 0.45, 95% CI 0.20-0.99, P = 0.04) of being in ASCVD quartile 4 (versus quartile 1).
Conclusion:
These findings contribute to mounting evidence of the diagnostic value of normal-range LDH levels, implicating normal-range LDH levels as a novel biomarker through which physical activity may be associated with CVD.
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