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Clinical Chemistry and Laboratory Medicine (CCLM)

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Volume 56, Issue 7


Higher D-lactate levels are associated with higher prevalence of small dense low-density lipoprotein in obese adolescents

Reyna Rodríguez-Mortera
  • Department of Medical Science, University of Guanajuato, Guanajuato, Mexico
  • Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA
  • Other articles by this author:
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/ Claudia Luevano-Contreras / Sergio Solorio-Meza / Russell Caccavello
  • Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA
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/ Yasmin Bains
  • Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA
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/ Ma Eugenia Garay-Sevilla / Alejandro Gugliucci
  • Corresponding author
  • Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA
  • Touro University-California, 1310 Club Drive, 94592, Vallejo, CA, USA
  • Email
  • Other articles by this author:
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Published Online: 2018-02-15 | DOI: https://doi.org/10.1515/cclm-2017-0733



Childhood obesity is associated with insulin resistance (IR), increased levels of small dense low-density lipoprotein (sd-LDL) as well as with augmented hepatic de novo lipogenesis, which implies increased triose phosphate fluxes that may lead to increased methylglyoxal (MG) and its catabolic end product D-lactate. We hypothesized that obese adolescents have increased D-lactate serum levels associated with high incidence of sd-LDL.


This is a cross-sectional study where the anthropometric characteristics, atherogenic dyslipidemia complex, sd-LDL (Lipoprint, Quantimetrix) and D-lactate (kinetic enzymatic analysis) were explored in 30 lean vs. 30 obese adolescents (16 females and 14 males per group) without metabolic syndrome (MetS). Endothelial function by flow-mediated dilation (FMD, by ultrasound) and arterial lesion by carotid intima media thickness (CIMT, by ultrasound) were also measured.


The mean age of participants was 16.8 ± 1.4 years. Obese adolescents had a body mass index of 32.7 ± 3.8 vs. 21.8 ± 2.1 in lean participants. The obesity group showed higher D-lactate levels: 6.2 ± 3.0 vs. 4.5 ± 2.5 μmol/L, higher levels of insulin: 15 (9.6–23.5) vs. 7.9 (6.5–10.5) μIU/mL; triglyceride (TG): 1.46 (1.1–1.8) vs. 0.84 (0.6–1.2) mmol/L; non-high-density lipoprotein-cholesterol (NON-HDL-C): 2.8 ± 0.9 vs. 2.3 ± 0.7 mmol/L; total cholesterol (TC)/HDL-C) index: 2.9 ± 0.7 vs. 2.4 ± 0.5; TG/HDL-C index: 2.2 (1.5–2.8) vs. 1.1 (0.8–1.8); %LDL-3: 4.2 ± 4.07 vs. 1.9 ± 2.7; smaller LDL size: 270.6 ± 3 vs. 272.2 ± 1.1 Å. D-lactate correlated positively with LDL-2: r = 0.44 and LDL-3 (sd-LDL): r = 0.49 and negatively with large LDL-1: r = −0.48 and LDL size: r = −0.46; (p<0.05, p<0.01, p<0.001 and p<0.0001, respectively). Obese adolescents showed higher CIMT: 0.51 ± 0.08 vs. 0.46 ± 0.08 mm and lower FMD: 20.3% ± 6.7% vs. 26.0% ± 9.3%.


Obese adolescents display subclinical signs of IR and endothelial dysfunction. Higher serum sd-LDL levels correlated positively with D-lactate levels. These findings suggest an association between atherogenic dyslipoproteinemia and whole body MG fluxes already detectable in apparently healthy obese adolescents.

Keywords: atherosclerosis; carotid intima media thickness (CIMT); D-lactate; flow-mediated dilation (FMD); insulin-resistance; LDL subclasses; metabolic syndrome; methylglyoxal; obesity


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About the article

Corresponding author: Alejandro Gugliucci, MD, PhD, Professor and Associate Dean of Research, Touro University-California, 1310 Club Drive, 94592, Vallejo, CA, USA; and Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA, Phone: +1 707 638 5237, Fax: +1 707 638 5998

Received: 2017-08-17

Accepted: 2018-01-10

Published Online: 2018-02-15

Published in Print: 2018-06-27

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: Grant DAIP University of Guanajuato (Project 011/2015) and Touro University-California (069).

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 56, Issue 7, Pages 1100–1108, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2017-0733.

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