Association of blood lactate with type 2 diabetes: the Atherosclerosis Risk in Communities Carotid MRI Study

Stephen O Crawford, Ron C Hoogeveen, Frederick L Brancati, Brad C Astor, Christie M Ballantyne, Maria Inês Schmidt, Jeffery Hunter Young, Stephen O Crawford, Ron C Hoogeveen, Frederick L Brancati, Brad C Astor, Christie M Ballantyne, Maria Inês Schmidt, Jeffery Hunter Young

Abstract

Background: Accumulating evidence implicates insufficient oxidative capacity in the development of type 2 diabetes. This notion has not been well tested in large, population-based studies.

Methods: To test this hypothesis, we assessed the cross-sectional association of plasma lactate, an indicator of the gap between oxidative capacity and energy expenditure, with type 2 diabetes in 1709 older adults not taking metformin, who were participants in the Atherosclerosis Risk in Communities (ARIC) Carotid MRI Study.

Results: The prevalence of type 2 diabetes rose across lactate quartiles (11, 14, 20 and 30%; P for trend <0.0001). Following adjustment for demographic factors, physical activity, body mass index and waist circumference, the relative odds of type 2 diabetes across lactate quartiles were 0.98 [95% confidence interval (CI) 0.59-1.64], 1.64 (95% CI 1.03-2.64) and 2.23 (95% CI 1.38-3.59), respectively. Furthermore, lactate was associated with higher fasting glucose among non-diabetic adults.

Conclusions: Plasma lactate was strongly associated with type 2 diabetes in older adults. Plasma lactate deserves greater attention in studies of oxidative capacity and diabetes risk.

Figures

Figure 1
Figure 1
Probability of type 2 diabetes across the distribution of blood lactate among 1749 older adults. Bars represent the distribution of lactate. The solid line denotes the predicted probability of type 2 diabetes (right axis); 95% CIs are shaded in grey; Triangles (bottom) represent the individual cases of type 2 diabetes
Figure 2
Figure 2
Association of triglyceride–HDL ratio with plasma lactate quartile among non-diabetics. Beta coefficients are adjusted for age, sex, high-IMT status, field centre, BMI and fasting glucose. Lactate quartiles are represented by the median lactate value within each quartile

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