What is the clinical evidence from this study?

Study design: Other. Intervention: Insulin and dichloroacetate (DCA) vs. Absence of insulin / baseline. Primary outcome: Contributions of lactate, pyruvate, and glucose to energy production.

What question did this study set out to answer?

This study aims to assess how lactate, pyruvate, and glucose contribute to energy production in the heart under varying insulin levels and after treatment with dichloroacetate.

July 1, 2003AJP Heart and Circulatory Physiology

Differential modulation of glucose, lactate, and pyruvate oxidation by insulin and dichloroacetate in the rat heart

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Key result

Insulin and dichloroacetate increased glucose and exogenous pyruvate oxidation, but not lactate oxidation, in isolated perfused rat hearts.

Population

isolated, perfused rat heart model

Comparison

perfusion with physiological concentrations of… vs absence of insulin

Design

Preclinical

Follow-up

45 min

Authors

SLSteven G. LloydUniversity of Alabama at Birmingham CBCharlye A BrocksUniversity of Alabama at Birmingham JCJohn C. ChathamHeart Failure & Transplant

Discussion

Member takes

Implication

In vitro rat heart data on lactate/pyruvate/glucose contributions leaves open in vivo relevance; human studies needed before clinical translation.

Key Points

This study aims to assess how lactate, pyruvate, and glucose contribute to energy production in the heart under varying insulin levels and after treatment with dichloroacetate.
Isolated, perfused rat hearts were used for the study.
Hearts were perfused with various labeled carbohydrates for 45 minutes.
13C NMR isotopomer analysis was performed on tissue extracts.
In the absence of insulin, glucose contributed only 25-30% to total pyruvate oxidation.
Pyruvate provided 10-30% of total acetyl-CoA entering the TCA cycle.
Insulin and DCA increased both glucose and pyruvate oxidation, but not lactate oxidation.

Structured PICO

Population

Isolated, perfused rat hearts used to determine the contributions of lactate, pyruvate, and glucose to energy production.

Intervention

perfusion with physiological concentrations of [1-13C]glucose, [U-13C]lactate, [2-13C]pyruvate, and unlabeled palmitate for 45 min, with varying insulin concentrations and dichloroacetate (DCA)

Comparator

absence of insulin

Outcome

contributions of lactate, pyruvate, and glucose to energy production (measured by 13C NMR glutamate isotopomer analysis on tissue extracts)surrogate

Insulin and DCA differentially modulate cardiac carbohydrate metabolism by increasing glucose and pyruvate oxidation but not lactate oxidation, providing evidence for compartmentation of cardiac carbohydrate metabolism.

Cite This Study

Lloyd et al. (2003) studied this question. Insulin and dichloroacetate (DCA) vs. Absence of insulin / baseline was evaluated on Contributions of lactate, pyruvate, and glucose to energy production. Insulin and dichloroacetate increased glucose and exogenous pyruvate oxidation, but not lactate oxidation, in isolated perfused rat hearts.

synapsesocial.com/papers/6a6d2e3bac440176ef26fe7e https://doi.org/10.1152/ajpheart.01117.2002

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Implication

In vitro rat heart data on lactate/pyruvate/glucose contributions leaves open in vivo relevance; human studies needed before clinical translation.

Differential modulation of glucose, lactate, and pyruvate oxidation by insulin and dichloroacetate in the rat heart

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Differential modulation of glucose, lactate, and pyruvate oxidation by insulin and dichloroacetate in the rat heart

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

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