Aim:
Elevated blood lactate, a marker of decreased oxidative capacity, may be associated with high levels of oxidized LDL and consequent atherosclerosis. We assessed the association between elevated blood lactate and carotid atherosclerosis in a sample of 1496 adults, aged 60 - 82 years, in the general population.
Methods:
Maximum wall thickness of the internal carotid artery (MICA) was measured using gadolinium-enhanced magnetic resonance imaging (MRI) in 1496 participants from the Atherosclerosis Risk in Communities (ARIC) Study. Blood lactate was categorized into quartiles (Q1: < 5.9 mg/dl, Q2: 5.9 to 7.2mg/dl, Q3: 7.3 to 9.2 mg/dl, and Q4: >9.2 mg/dl).
Results:
Mean age was 70.3 years; 56% were women and 19% were African American. Higher lactate quartile was associated with greater odds of having MICA above the median (Odds ratio for Q1: 1.00, Q2: 1.06, Q3: 1.24 and Q4: 1.36; p for trend <0.001) after adjustment for age, gender, ethnicity, stature, body mass index (BMI), LDL, hypertension diagnosis, and diabetes diagnosis. The association between MICA and lactate was attenuated but remained significant (Q1: 1, Q2: 1.02, Q3: 1.12, Q4: 1.21, p for trend 0.011) after further adjustment for triglycerides/HDL ratio.
Conclusion:
Blood lactate is associated with internal carotid artery maximum wall thickness, a marker of carotid atherosclerosis. Attenuation of the association with adjustment for triglyceride/HDL ratio, a marker of insulin resistance, suggests that lactate’s association with wall thickness may be mediated through insulin resistance, at least in part.
Association of Coronary Heart Disease Incidence with Carotid Arterial Wall Thickness and Major Risk Factors: The Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993
