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 blood lactate with carotid atherosclerosis: The Atherosclerosis Risk in Communities (ARIC) Carotid MRI Study