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Plasma lactate and diabetes risk in 8045 participants of the atherosclerosis risk in communities study.

TitlePlasma lactate and diabetes risk in 8045 participants of the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2013
AuthorsJuraschek SP, Selvin E, Miller ER, Brancati FL
Secondary AuthorsYoung HJ
JournalAnn Epidemiol
Volume23
Issue12
Pagination791-796.e4
Date Published2013 Dec
ISSN1873-2585
KeywordsAdult, Aged, Atherosclerosis, Biomarkers, Blood Glucose, Community-Based Participatory Research, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Incidence, Insulin, Insulin Resistance, Lactic Acid, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Residence Characteristics, Risk Factors, United States
Abstract

PURPOSE: Determinants of oxidative capacity, such as fitness and level of adiposity, are strongly associated with type 2 diabetes. Whether decreased oxidative capacity itself is a cause or consequence of insulin resistance and diabetes is unknown.

METHODS: We examined the association of plasma lactate, a marker of oxidative capacity, with incident diabetes in 8045 participants from the Atherosclerosis Risk in Communities (ARIC) Study with no history of subclinical or diagnosed diabetes at baseline (1996-1998). Incident diabetes was self-reported during annual telephone calls.

RESULTS: During a median follow-up of 12 years, there were 1513 new cases of diabetes. In Cox proportional hazards models, baseline plasma lactate (per 10 mg/dL) was significantly associated with diabetes (hazard ratio, 1.20; 95% confidence interval, 1.01-1.43), even after adjustment for diabetes risk factors, fasting glucose, and insulin. The upper quartile of baseline lactate (≥ 8.1 mg/dL) was also significantly associated with diabetes risk (hazard ratio, 1.20; 95% confidence interval, 1.02-1.41) compared with the lowest quartile (≤ 5.1 mg/dL). Significant associations persisted among persons without insulin resistance (homeostatic model assessment insulin resistance index

CONCLUSIONS: These findings suggest that low oxidative capacity may precede diabetes. Future studies should evaluate the physiological origins of elevated lactate to better understand its possible role in the pathogenesis of diabetes.

DOI10.1016/j.annepidem.2013.09.005
Alternate JournalAnn Epidemiol
PubMed ID24176820
PubMed Central IDPMC4034672
Grant ListHHSN268201100005C / / PHS HHS / United States
R01DK085458 / DK / NIDDK NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
P30 DK079637 / DK / NIDDK NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
5P60DK079637-04 / DK / NIDDK NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
R01 DK085458 / DK / NIDDK NIH HHS / United States
P60 DK079637 / DK / NIDDK NIH HHS / United States
T32HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100006C / / PHS HHS / United States