LACTATE CAN BE A MARKER OF METABOLIC SYNDROME IN SEVERE OBESITY?

Background: In the last decades, numerous studies have confirmed the importance of lactate - by-product to the nutrient signal of the intracellular redox state - to regulatory functions in energy metabolism.

Aim: To evaluate changes in blood lactate in patients with severe obesity and its correlation with body composition and metabolic profile.

Methods: Twenty-four people with severe obesity (BMI=40 kg/m2) were evaluated in a prospective case-control study before and six months after Roux-in-Y gastric bypass. The blood lactate, total cholesterol, and fractions, C-reactive protein and HOMA-IR were analyzed after 12 h fasting. Body mass composition was evaluated by bioelectrical impedance and respiratory quotient was measured by indirect calorimetry.

Results: The initial lactate level was 2.5±1.1 mmol/l and returned to normal level (1.9±3.6 mmol/l, p=0.0018) after surgery. This reduction was positively correlated with a decrease in BMI (p=0.0001), % free fat mass (p=0,001), % fat mass (p=0.001) and HOMA-IR (p=0.01). There was normalization of lactatemia in 70% of patients. There was no correlation between lactatemia and C-reactive protein.

Conclusions: There was a significant improvement of metabolic parameters, normalization of blood lactate, fat mass loss, although these individuals remained with a high BMI.