Plasma lactate and its association with adiposity and biomarkers of cardiometabolic risk

Lactate has been of recent interest as a novel clinical biomarker of cardiometabolic disfunction and disease. The purpose of this cross-sectional study was to expand on existing understandings of the etiology of increased resting lactate and how traditional cardiometabolic risk factors associate with lactate concentration.

Three hundred and eighty-two adult (39.2 ± 1.4 years) females (47%) and males were included. Body composition measures were determined via dual X-ray absorptiometry (DXA). Blood pressure and blood metabolites were determined following an overnight fast, prior to a hyperinsulinemic-euglycemic clamp to determine insulin sensitivity. Lactate was determined from aliquoted plasma using a biosensor based electrochemical analyzer. A cardiometabolic risk score (CRS) was developed using the average of standardized deviates of main cardiometabolic risk factors. Associations between adiposity and lactate, adjusting for sex, and associations between lactate and cardiometabolic factors, adjusting for sex and BMI, were assessed using multiple linear regression modeling. Linear regression models show significant positive associations between lactate and BMI, DXA derived measures of adiposity, as well as total lean body mass. Significant positive associations were observed between lactate and insulin resistance, insulin, triglycerides, total cholesterol, diastolic blood pressure, and CRS; and a significant negative association observed between lactate and high-density lipoprotein cholesterol.

Increased adiposity is shown to be a predictor of increased lactate, which in turn is associated with worsened cardiometabolic risk factors, including insulin resistance. These findings suggest lactate, driven in part by increased adiposity, may serve as a valuable biomarker of heightened cardiometabolic risk.