Measurement of pyruvate and lactate kinetics

across the hindlimb and gut of anesthetized dogs

DAVID L. CHINKES, XIAO-JUN ZHANG, JOHANNES A. ROMIJN,
YOICHI SAKURAI, AND ROBERT R. WOLFE
Metabolism Unit, Shriners Burns Institute; and University of Texas Medical Branch,
Galveston, Texas 77550

Chinkes, David L., Xiao-Jun Zhang, Johannes A. studies may reveal important information about the
Romijn, Yoichi Sakurai, and Robert R. Wolfe. Measure- rate of release of lactate into the circulation (3, 17, 27),
ment of pyruvate and lactate kinetics across the hindlimb and information about lactate production or oxidation is not
gut of anesthetized dogs. Am. J. Physiol. 267 (Endocrinol. obtained. Arteriovenous balance techniques, with or
Metab. 30): E174-E182, 1994.-We have developed a new without a tracer infusion, reveal information about the
model to quantify regional pyruvate and lactate transmem- net extraction and release of lactate across the tissue bed
brane transport, shunting, exchange, production, and oxida- being measured (7, 22, 25). However, arteriovenous
tion in vivo. The method is based on the systemic continuous balance techniques do not yield the rate of production or
infusion of pyruvate or lactate stable isotopic carbon tracers oxidation of lactate in the tissue, nor do they yield the
and the measurement of pyruvate and lactate enrichment and
rate of transmembrane transport in the tissue (6, 11).
concentration in the artery and vein of that region (e.g., leg or
We are unaware of any studies in the literature in which
gut), the pyruvate and lactate enrichment of intracellular free
water in the tissue as measured by biopsy, and the rate of blood production, oxidation, and transmembrane transport
flow through the tissue. The purpose of the experiment was to were measured in vivo at the tissue level.
measure the pyruvate and lactate kinetics in leg muscle and We previously described a method to measure the rate
gut in anesthetized dogs (n = 6). The transmembrane trans- of transmembrane transport, production, and oxidation
port and degree of shunting of pyruvate and lactate were of amino acids in vivo at the tissue level (2). Here we
comparable in muscle and gut. When modified for substrate have applied the principles developed in our amino acid
inflow, interconversion between pyruvate and lactate took model to lactate and pyruvate metabolism. The model
place at a rate twice as fast in muscle as in the gut, and used to calculate transmembrane transport, exchange,
production and oxidation of pyruvate was - 50% greater in production, and oxidation of pyruvate and lactate in-
muscle than in the gut. Thus our new model enables quantita- volves the measurement of the intracellular pyruvate
tion of many aspects of lactate and pyruvate kinetics. We
conclude that in anesthetized animals the muscle is the tissue and lactate enrichments and also the arteriovenous
most responsible for whole body peripheral pyruvate and differences of pyruvate and lactate tracer and tracee
lactate kinetics. across the tissue of interest during a constant infusion
of labeled pyruvate or lactate. Furthermore, we have
arteriovenous difference; stable isotopes; transmembrane applied this new model to the quantification of the
transport; production; extraction; oxidation
pathways of lactate metabolism in the hindlimb and gut
of the anesthetized dog.

LACTATE AND PYRUVATE play a central role in intermedi- METHODS

ary metabolism. General aspects of lactate and pyruvate The experiments were performed in six anesthetized over-
metabolism that are of interest are the rate of transport night-fasted dogs (20.5 t 1.6 kg body wt). After a bolus intra-
across cell membranes, the degree to which this rate of venous injection of pentobarbital sodium (30 mglkg), polyeth-
transport can be altered, and the rates of production and ylene catheters were placed in the carotid artery, femoral vein,
oxidation of lactate and pyruvate by tissues. All these left external jugular vein, and mesenteric vein. The catheter in
parameters are likely to play an important role in states the left external jugular vein was used for infusing the tracer,
such as high-intensity exercise and severe sepsis, in and samples were obtained from the other catheters. The right
which a high lactate concentration is an important femoral vein was dissected for a 4-cm portion to install a length
physiological response. For example, in vitro data sug- of tubing with a Y-shaped connector, which was used for blood
sampling and measurement of blood flow. The blood flow rate
gest that the capacity to transport lactate is affected by
was determined by clamping the cephalic side of the Y-shaped
training (19), so it probably is possible to alter transport femoral vein tubing and measuring the volume of blood
in vivo as well. In severely stressed patients, high lactate discharged from the free end in a 10-s interval. Additional
concentrations occur independently of systemic hypoxia pentobarbital (1 mg. kg-l. minl) and 0.9% saline were given
(27), suggesting an important relationship between the throughout the experiment to maintain a constant level of
stimulation of pyruvate production from glycolysis and anesthesia and a normal hydration. The level of anesthesia
the release of lactate into the blood. Whereas whole body was judged by heart rate, cornea1 reflexes, and blood pressure.

El74 019%1849/94 $3.00 Copyright G 1994 the American Physiological Society

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 PYRUVATE AND LACTATE KINETICS ACROSS HINDLIMB AND GUT El75

At the end of the experiment, the animals were killed by vate, and the NAP derivate of alanine, as described previously
injection of euthanizing agent T-61. This study was approved (26). Isotopic enrichment of derivatized plasma samples was
by the Animal Welfare Committee of The University of Texas determined by gas chromatography-mass spectrometry with a
Medical Branch. Hewlett-Packard 5985B gas chromatography-mass spectrom-
Experimental design. After collection of blood samples for etry system, as described in detail previously (26), and CO2
the determination of background isotope enrichment, enrichment was measured using a SIRA II isotope ratio mass
[U-13C]pyruvate (n = 4) or 11-13C]lactate (n = 2) was given as spectrometer (Fision Instruments, Dearborn, MI; Ref. 26).
a constant infusion at 1.0 (n = 5) or 2.0 (n = 1) pmolkg-l. Isotopic enrichment, expressed as tracer-to-tracee ratio, was
min-l for 6 h (with a priming dose of 15 pmol/kg for all dogs). determined as described previously (2 1).
Both tracers (99% atom percent excess) were purchased from To assess the measurement error in calculating the tracer-
MSD (Montreal, Canada). Blood was drawn at 1.5,3,4.5, and 6 to-tracee ratio, we took five aliquots of the same background
h of infusion from the carotid artery, femoral vein, and sample and processed them separately and analyzed each five
mesenteric vein. The blood samples were transferred immedi- times on the mass spectrometer. This gave us separate quanti-
ately into prechilled tubes containing methyl alcohol (for fication of the error of replicate injections of the same sample
determination of pyruvate concentration and enrichment), into the mass spectrometer and also the total error of analysis
ethyl acetate (lactate enrichment), and fluoride (lactate concen- (including variability arising in the derivatization procedure).
tration). At 0 and 6 h, tissue biopsies were taken from skeletal The total coefficients of variation in the determination of the
muscle (soleus) and gut. All tissue biopsies were obtained relative abundances of the 2M + 1, 2M + 2, and 2M + 3
using the “freeze-clamp” technique ( N l-2 g/sample). The isotopomers of naturally occurring lactate were 0.43, 1.9, and
tissue was rapidly blotted and immediately frozen in liquid 3.0%, respectively. The coefficients of variation for replicate
nitrogen and stored at -80°C until analysis. Plasma was also injections of the same samples into the mass spectrometer
frozen until later analysis. were 0.52, 1.7, and 2.1% for the 2M + 1, M + 2, and M + 3
Analyses of samples. Arterial plasma glucose and whole isotopomers, respectively, meaning that virtually all error was
blood lactate concentrations were determined on a glucose in the mass spectrometer analysis and not the derivatization
analyzer (Beckman Instrument, Fullerton, CA) and on a procedure. Because the tracer-to-tracee ratio is the difference
lactate analyzer (Yellow Springs Instrument, Columbus, OH), between the abundance of one isotopomer after tracer infusion
respectively. Alanine and pyruvate plasma concentrations and before infusion, the error in computation of that ratio is
were measured by the internal standard method with use of dependent on the level of enrichment. For example, the
L-[1,3,3,3-2H4Jalanine (26>, and singly or triply labeled pyru- calculation of a tracer-to-tracee ratio of 0.02 of singly labeled
vate (depending on the tracer infused) was used as the internal lactate would have a coefficient of variation of N 5%.
standard for the determination of blood pyruvate concentra- CaZcuZations. The new model used to represent the tracee
tion; 0.005 pmol of labeled pyruvate internal standard was pyruvate and lactate kinetics of the hindlimb is pictured in Fig.
added for each milliliter of blood. 1. It is assumed that the tracer and the tracee are at a steady
The blood samples were processed to make the trimethylsilyl state; i.e., none of the variables change over time. F represents
derivative of lactate, the silylquinoxalinol derivative of pyru- rate of flow of substrate from one compartment to another

FLV,A
FrV,A

Lactate from
other veins

Fig. 1. Model of tracee kinetics of lactate and pyruvate. Equilibration of pyruvate and lactate in whole blood causes
most tracee entering artery to be in form of lactate. Lactate and pyruvate interact with tissue as shown. Lactate and
pyruvate exiting vein mixes with other veins and reenters artery. See text for definitions.

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El76 PYRUVATE AND LACTATE KINETICS ACROSS HINDLIMB AND GUT

(pmollmin). These variables are different from the rate con- between pyruvate and lactate occurs in whole blood within 3-5
stants used in compartmental modeling, which represent frac- min (20). On the other hand, there is little equilibration in 20 s
tional rates of flow (mml). In our model, the only equations (20), which i s approximately the time required for lactate and
used to derive all tracer and tracee flows are the mass balance pyruvate to pass through muscle and appear in a femoral
equations of tracer and tracee, i.e., the equations that state venous sample. For this reason, there are no arrows connect-
that the flow of tracer and tracee into each compartment must ing the venous lactate and pyruvate compartments (Lv and
be equal to the flow of tracer and tracee from that compartment. Pv). The effect of the recycled labeled lactate is taken into
Pyruvate and lactate flow into the hindlimb at rates FPi, account implicitly by considering the arteriovenous difference
and FLin, respectively, and out of the hindlimb at rates FPout of the amount of label flowing through the leg rather than the
and FLout, respectively. Some pyruvate and lactate does not rate at which the label is infused. As we noted before, because
enter the intracellular space but passes directly from artery to the exchange of pyruvate and lactate has already taken place
vein (shunts) at rates FPv,A and FLv,*, respectively. The
before they reach the arterial catheter, it is impossible to
pyruvate and lactate that enter the intracellular space do so at
distinguish the kinetics of pyruvate and lactate at the whole
rates FPT,A and FLT,* and then exit the intracellular space
back into venous blood at rates FPv T and FLv T. Pyruvate and body level (29). However, by using this model, it is possible to
lactate exchange in tissue at the rates FpT LT and FLTpT as distinguish pyruvate and lactate kinetics at the tissue level.
shown. Finally, there is production and uptake of pyruvate in The rate of flow of tracee into and out of the hindlimb is
the tissue at rates P and U. readily obtained by multiplying the flow rate of plasma across
The model used to represent the tracer pyruvate and lactate the hindlimb (Fplasma) by the arterial or venous tracee concen
kinetics is identical to the tracee model (Fig. 2>, except flows tration. For example, FLi, is equal to the arterial lactate con
are denoted with lower-case rather than upper-case letters centration times the flow rate of plasma across the hindlimb
(e.g., fPT,A rather than FPT,A), and there is no production of
pyruvate tracer in tissue. It is assumed that the tracers have FLin = [arterial La] x Fplasma (1 )
no effect on the kinetics of this system. This may be slightly in FPin = [arterial Pyr] x Fplasma (2
error, because stable isotopes are not massless. However,
because the measured enrichments are all < 4% (seeRESULTS), FLout = [venous La] x Fplasma (3
the assumption is reasonable.
It also is assumed that any isotopic exchange between FP,,t = [venous Pyrl x Qasma (4)
pyruvate and lactate in whole blood occurs before the blood where La is lactate and Pyr is pyruvate. The tracer flows into
enters the femoral artery (see RESULTS), so there are no flows and out of the hindlimb can be obtained by multiplying the
connecting the arterial lactate and pyruvate compartments tracee flows by the appropriate enrichment, i.e.
(LA and PA). This means that, in effect, both lactate and
pyruvate tracers are being infused even though only one of the fLi, = FLi, X EL* (5)
substrates is exogenously introduced. There is time for lactate
and pyruvate to equilibrate in the arterial blood, because some fPi, = FPi, X EPA (6)
of the labeled lactate flowing into the artery will have recycled
fL out= FL,,, x EL, (7)
through the circulation a few times (20), and the average
circulation time (i.e., cardiac output divided by blood volume) fP out= FPout x EPV (8)
is 1 min (14). We have shown that extensive equilibration
where EL*, EPA, EL v, and EPv are the enrichment (i.e.,
tracer-to-tracee ratio) of lactate and pyruvate in the artery or
vein.
The net balance of lactate and pyruvate tracer across the leg
4n
(nb) is the diff erence between the flows into and out of tracer,
or

nb = fLi, + fpi, - (fL,,t + fp,,t) (9)

Because we are at steady state, the uptake of tracer in tissue
(u; in the form of pyruvate) must be equal to the above net
balance, i.e.
u = nb (10)
fPVtA An alternative, independent method of calculating nb is consid-
eration of the net production of 13C02 across the leg with the
assumption that all 13C02 produced in the leg came from the
pyruvate tissue pool.
The ratio of the rate of uptake of tracer to the rate of uptake
of tracee is equal to the tracer-to-tracee ratio at the site of
uptake, or

EPT = u/u (11)

fL out fpout where EPT is the enrichment of pyruvate in tissue. Therefore,

solving for U yields
Fig. 2. Model of tracer kinetics of lactate and pyruvate. This model is
the same as tracee model, except there is no intracellular production of U = u/EPT (12)
tracer. Equilibration in whole blood causes most tracer to be in form of
lactate, regardless of whether pyruvate or lactate is infused. so U can be calculated.

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 PYRUVATE AND LACTATE KINETICS ACROSS HINDLIMB AND GUT El77
The net balance of tracee across the leg (NB) is the lactate in the muscle that came from lactate in the artery as
difference between the flow in and the flow out, i.e. follows

NB = FL,, + FPi, - (FL,,, + FP,,,) (13) FLTA/@‘L,A

9 7 + FL, ,pT) = (ELT - EPT)/(ELA - EPT) (25)
The rate at which lactate in tissue is accumulated from all
The net balance of tracee across the leg must be equal to the
sources (FLT,all = FLT,A + FLT,PT) is the rate at which lactate
difference between production and uptake of tracee in the leg,
so flows in from the artery divided by the percentage of lactate in
the tissue that came from the artery, i.e.
P=U-NB (14) FL T7all = FLT 9A/[(ELT - EP,)/(EL, - E&)1 (26)
One principle that is used in the following calculations is Therefore the rate at which pyruvate in tissue is converted to
that if a pool X (with enrichment Ex) has two sources Y and 2 lactate in tissue is the difference between the rate at which
with different enrichments EY and Ez, then the percentage of lactate in tissue is accumulated from all sources minus the rate
the flow into pool X that came from source Y [Fx,y/(Fx,y + at which lactate flows in from the artery, or
Fx,dl is
F LT,PT = FLT,,ll - FLT,A (27)
FxY/(FXY+
7 F,,)7 = 100% x (E,- &>/U$- E,) (15)
The flow into the lactate pool must be equal to the flow out of
Equation 15 is derived in general from the fact that the the lactate pool, i.e.
percentage of the flow into pool X that came from source Y plus
the percentage of the flow into pool X that came from source 2 FLT,A + FLT,PT = FLV,T + FPT,LT (28)
[Fxz/(Fxy
7 7 + F&l, must equal lOO%, i.e.
SO solving for FpT,LT yields
FxYI(Fxy
9 , + F,,), + F,,/W,,
9 7 + F,,), = 100% (16) F PTLT> = FLTA 7 + FLTPT7 - FLVT 7 (29)
Also, the relationship between the three enrichments is that Hence all tracee flows in the model have been obtained.
the enrichment of pool X is the percentage of the flow into X Blood flow rates in the gut were not measured, so the blood
that came from Y times the enrichment of pool Y plus the flow rate across the gut was assumed to be 213 ml/min, the
percentage of the flow from X that came from 2 times the same as the blood flow rate across the hindlimb. This value is
enrichment of pool 2, i.e. not significantly different from that reported in the literature
Ex = lFxyl(Fxy in dogs anesthetized with pentobarbital (14). Choosing hind-
, 9 + F,,)IE,
, + lFxzl(Fxy
, 7 + Fxz)lEZ
, (17) limb and gut blood flow rates to be the same means that the
Solving Eqs. 16 and 17 for Fx r/(Fx y + Fx,z) yields Eq. 15. reported kinetic factors will be equal to the kinetic factors
We can apply the above general rule to find the percentage of obtained after normalizing for blood flow rate and allows
lactate in venous blood that came from the artery, because comparisons of the muscle and gut data. Changing the blood
there are two sources of lactate (shunting from artery and flow by a certain percentage causes all substrate flows to
release from tissue) with known enrichments. The percentage change by the same percentage. In other words, if the blood
of lactate in venous blood that came from the artery via flow was doubled, the calculated values of all flows in Fig. 5
shunting rather than from tissue would be would be doubled. Hence if the assumed gut blood flow rate is
incorrect, this will not affect the relationship between flows,
FLV,A/FLOUt- -Fb,A/(Fb,+FJ+,T) = (EL, - ELT)/(ELA - ELT) such as the percent lactate extracted or the percentage of
intracellular pyruvate oxidized. Therefore the sensitivity of
(18) these measurements is unaffected by the blood flow rate. Only
the absolute kinetic factors will be affected, such as de novo
Therefore the flow of lactate tracee from arterial to venous production rate of pyruvate, and the error in the estimation of
blood is these measurements will be directly proportional to the error
in assuming that the gut blood flow rate is 213 ml/min.
FLV 9A = FL,,, X (EL, - EL,)/(ELA - EL,) (19)
Statistics. To assess whether the variability in the data
Similarly, the flow of pyruvate tracee from arterial to venous causes the variability of the calculated kinetic factors shown in
blood is Fig. 1 to be overly large, the effect of variability in enrichments
in the denominators of the flow formulas presented in CczZcuZa-
FPVA 9 = FP,,, X (EPv - EP,)/(EPA - EPT) (20) tions must be assessed. For example, if the tissue pyruvate en-
richment (EPT) was not statistically different from zero, then
The rate of flow of tracee from tissue to the vein is the U = nb/EPT could theoretically yield any value, because one
difference between the flow out and the shunting, i.e. would be dividing by a number arbitrarily close to zero. The
magnitude of the differences between enrichments in denomi-
FLvT = FL,,, - FLvA, (21) nators of the flow formulas are of concern for the same reason.
For example, if FLvA = FL,,t x (ELv - ELT)/(ELA - ELT) is
FPV,T = FP,,, - FPV,A (22)
being used, ELA - ‘ELT must be significantly different from
The rate that tracee flows from the artery into the tissue is the zero. Consequently, the paired t test was used with the pairs
difference between the flow into the leg and the shunting, or ELA and ELv, EPA and EPv, ELv and ELT, EPv and EPT, and
ELT and EPT. The enrichments were determined to be nonzero
FL,, = FL,, - FLvA (23) with use of the t test.
FP T,A = FPin - FpV:, (24) RESULTS

Lactate in tissue has two sources, lactate from the artery and The average slope of every plasma measurement
pyruvate in tissue, so we can determine the percentage of (enrichments and concentrations) from 3 to 6 h plotted

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 El78 PYRUVATE AND LACTATE KINETICS ACROSS HINDLIMB AND GUT

against time was not significantly different from zero Table 1. Summary of measured enrichments
(P > 0.4 for every plasma measurement), implying that and concentrations
a steady state would be reached within 3 h (Fig. 3). The
amount of tracer flowing into the hindlimb and gut Lactate Pyruvate
(arterial concentration x blood flow) in the form of Concentration, pmol/ml
lactate was similar with a pyruvate or lactate infusion. Arterial 0.77 t 0.15 0.09 + 0.02
The net balances of lactate and pyruvate across the leg Femoral vein 1.00 + 0.15 0.05 + 0.01
Mesenteric vein 0.91 f 0.17 0.06 f 0.01
were -46.1 t 10.9 and 6.9 t 3.3 kmol/min, respectively. Enrichment
The blood flow rate across the hindlimb was 213 t 14 Arterial 0.048 t 0.013 0.051+ 0.008
ml/min. A summary of the other measured parameters Femoral vein 0.030 2 0.007 0.023 + 0.005
is presented in Table 1. Muscle 0.011 + 0.002 0.006 * 0.001
Mesenteric vein 0.040 t 0.016 0.032 f 0.009
Calculated kinetic factors (means t SE) in the hind- Gut 0.018 + 0.001 0.011 f 0.002
limb and gut are shown in Figs. 4 and 5, respectively. As
Values are means + SE; enrichments are expressed in tracer-to-
tracee ratio.
A

shown in Fig. 3, all enrichments and differences between

enrichments that must be nonzero are in fact statisti-
4- cally different from zero, as determined by the paired t
test (P < 0.05). In all cases, the pyruvate tissue enrich-
2- ment was lower than the lactate tissue enrichment. The
A difference between arterial pyruvate and lactate enrich-
0 1 1 I 1 f ments was not statistically different from zero, which
1 2 3 4 5 6 supports the assumption that no further equilibration
8 B
of pyruvate and lactate could take place in whole blood
1 before they enter other tissues. The labeled CO2 produc-
tion across the leg was 71.7 t 14.8% of the total net
tracer uptake.
The rates of most of the pathways in the gut are
similar to the corresponding kinetic factors in the
hindlimb. The main differences were that the intracellu-
lar lactate-pyruvate interconversion in the intestine was
z 0 I A -40% of that in muscle and that the net release of
1 I I 1 lactate was much smaller in the gut (-6.9 t 16.9 pmol/
2 3 4 5 6
min) than in muscle (-46.1 t 10.9 kmol/min). Produc-
tion and uptake of pyruvate was slightly lower in the
intestine than in the hindlimb, but the rate of transport
of pyruvate and lactate into and out of tissue was
similar. Because the rate of blood flow through the gut is
much slower than the total blood flow rate through all
muscle and the production rate of pyruvate in gut is
lower than the production rate of pyruvate in muscle
when normalized for the blood flow rate, the production
0 ! I I 1 1 1 rate of pyruvate must be considerably greater in resting
1 2 3 4 5 6 muscle than in gut.
DISCUSSION

The modeling of lactate with two pools representing

arterial and venous blood was initially done by Katz et
al. (10). A more comprehensive model was presented by
Stanley and Lehman (23). The addition of a lactate
tissue compartment enabled the effect of shunting past
b
A tissue to be included in an explicit manner, which
z
0 I 1 I I 1
Lehman and Brooks (13) estimated to be - 50%. Shunt-
1 2 3 4 5 6 ing in this case means that lactate goes from the artery
time (hours) to the vein without entering the intracellular space.
Fig. 3. Plasma and tissue enrichments. A and B: enrichments across Shunting thus includes the lactate that goes through
hindlimb of lactate and pyruvate, respectively. C and D: enrichments the capillaries of organs that do not readily take up
across gut of lactate and pyruvate, respectively. 0, Arterial enrich-
ments; i-1, femoral vein enrichments; n, muscle enrichments; W,
lactate. The fact that shunting is significant means that
mesenteric vein enrichments; A, gut enrichments. All enrichments in the tissue enrichment must be lower than the venous
A-D are statistically different (P < 0.05). enrichment. In the model of Stanley and Lehman (23), a

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 PYRUVATE AND LACTATE KINETICS ACROSS HINDLIMB AND GUT El79

168f36 18.3 f 5.7

h Lactate in
Artery

115f26 Fig. 4. Results of muscle data. All units

4.4 * 0.9 (means t SE) are kmol/min.

pyruvate tissue pool was attached to the lactate tissue We have for the first time measured the pyruvate
pool to account for the fact that pyruvate and lactate enrichment of muscle and gut resulting from a constant
exchange in tissue. From this model, it was shown infusion of pyruvate or lactate. Because one would
formally that the oxidation rate of lactate could in expect the enrichment of pyruvate and lactate to vary
theory be obtained by dividing the infusion rate by the from tissue to tissue because of differences in transport,
enrichment of pyruvate in tissue (24). However, the production, and oxidation, we modified the model of
enrichment of pyruvate in non-red blood cell tissue has Stanley and Lehman (23) further to quantify the trans-
never been measured in vivo under these circumstances. membrane transport rate of lactate and pyruvate, lactate-

168k36 18.3 f 5.7

Fig. 5. Results of gut data. All units

llBf23 (means + SE) are approximately equal to
3.2 f 0.6
kmol/min.

10.1 f 2.5
172i36

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El80 PYRUVATE AND LACTATE KINETICS ACROSS HINDLIMB AND GUT

pyruvate interconversion rates, and production and oxida- than the venous enrichment (12). The differences in the
tion rates of pyruvate in muscle and gut. Our new model is findings of the current and the former study probably
based on the measurement of pyruvate and lactate enrich- stem from refinements in processing the tissue samples.
ments in tissue and in arterial and venous blood, the In the current study, we took smaller samples and
measurement of pyruvate and lactate concentrations in ground them up to a greater extent, which reduces the
arterial and venous blood, and the rate of blood flow likelihood of the intracellular measurement being con-
through the tissue being measured. In addition to the taminated by extracellular lactate. The intracellular
importance of being able to quantify several aspects of enrichment of pyruvate has not been measured before,
lactate and pyruvate kinetics for the first time, an important so it is not possible to assess its accuracy by comparing it
advantage of the model of limb metabolism is its potential with previous results. However, the fact that it is close
for transfer to the application in a human subject. to the lactate enrichment is consistent with in vitro data
In our model, we assumed that the muscle biopsy is that the maximal enzyme activity of lactate dehydroge-
representative of the hindlimb tissue. We also assumed nase in muscle has been found to be > 100 times larger
that blood flow across the leg primarily perfuses muscle. than the maximal glycolytic flux (16), which supports
The basis for this assumption is the finding that 70% of the notion of rapid lactate-pyruvate exchange in tissues.
blood flow across the leg goes to muscle, while the Consequently we believe the current results of tissue
remainder goes to bone (lo%), skin (lo%), and shunts enrichment to be more accurate.
(10%) (18). We h ave considered lactate and pyruvate The rate of pyruvate production in muscle cannot be
transport in bone to be minimal, and we assumed that fully accounted for by the observed rate of loss of glucose
transport in skin was similar to that in muscle. Muscle across the hindlimb. It is possible that the surgical
tissue was assumed to be homogeneous. This is justifi-
stress of the experiment caused an increased rate of
able on the grounds that dog skeletal muscle fiber is
glycogenolysis and a higher rate of pyruvate production
basically all of the oxidative type ( 15).
The limb net balance data from our experiment are than might be expected in resting muscle. The effect of
similar to the results reported by several other investiga- alanine on pyruvate and lactate kinetics was considered
tors, including results in humans (when normalized for using a model that adds alanine arterial, venous, and
blood flow) (7,22). Because blood flow was not measured tissue pools to Fig. 1, and it was concluded that alanine
in all previous experiments, the extraction of tracer contributes < 10% of intracellularly produced pyruvate.
from the circulation is often computed in tracer arterio- We have used carbon tracers to quantify pyruvate and
venous difference studies. Stanley et al. (22) found that lactate kinetics. We would expect different enrichments
the extraction of lactate across the leg in humans is to result if a [3-3H]lactate tracer is used, because the
- 40% in rest and exercise. Brooks et al. (4,5) found that hydrogen label will be lost when lactate is converted to
extraction across the leg in humans was 47 and 30% in pyruvate. The specific activity of lactate in plasma result-
rest and exercise, respectively. This compares well with ing from the infusion of [3-3H]lactate tracer has indeed
our measurement of 36 t 7%. Measurements across the been observed to be one-half of the specific activity ob-
human forearm yielded a slightly lower extraction of served when a comparable dose of [U-14C]lactate is in-
2830% (7, 22) or a higher extraction of 41% (4, 5). In fused (17). This is consistent with our model, which pre-
our experiment, 72% of the net loss of tracer across the dicts that approximately one-half of the arterial lactate
leg was released as labeled COB. In a previous study by will exchange with pyruvate before reaching a vein.
Jorfeldt (9) in humans, only 52% of the lactate tracer The results of this study have implications for a
across the forearm was recovered as C02. It has been number of methods used to study lactate metabolism.
suggested, however, that because in Jorfeldt’s study the The net balance of substrates is commonly used as an
duration of the infusion was only 6-7 min, the labeled index of production and/or oxidation in tissue. From our
CO2 in the muscle probably did not equilibrate with the model, we see that the actual production rate of pyru-
intramuscular bicarbonate pool, resulting in an underes- vate in muscle and gut is an order of magnitude larger
timation of the true fraction of oxidation (22). Because than the net balance of pyruvate and lactate combined,
the infusion time in our study was much longer, this was so clearly the net balance of either pyruvate or lactate is
less likely to be a problem. Gertz et al. (8) found that a poor indicator of pyruvate production, because most
85% of the net loss of tracer across the myocardium was pyruvate produced in muscle and gut is oxidized without
released in humans as C02. Because the myocardium ever entering plasma. However, the net balance measure-
contains more mitochondria than skeletal muscle, we ment is useful, because it enables the assessment of
would expect a higher percentage of tracer to be oxidized whether a particular tissue is a net consumer or pro-
in the myocardium than in the skeletal muscle. Our ducer of lactate.
current results agree with our previous findings that There are two formulas for estimating the rate of
venous pyruvate and lactate enrichments are similar appearance (R,) of a substrate across a tissue bed by use
after an arterial infusion of lactate (28) and that lactate of tracers and only arteriovenous measurements (1)
enrichments are similar when pyruvate or lactate is
infused (29).
R al = (E,/E, - 1) x arterial concn X Fplasma (30)
In contrast to the instances in which our data agree and
with previous results, earlier we reported that the
muscle enrichment of lactate was not significantly lower R a2= (1 - Ev/E,) X venous concn X Fplasma (31)

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Copyright © 1994 American Physiological Society. All rights reserved.
 PYRUVATE AND LACTATE KINETICS ACROSS HINDLIMB AND GUT El81

If we substitute the lactate concentration and enrich- Hospital Grant 15849. J. A. Romijn was supported by a grant from the
Netherlands Organization for Scientific Research.
ment measurements across the hindlimb into Eqs. 30 Address for reprint requests: R. R. Wolfe, Metabolism Unit, Shri-
and 31, we obtain R,l 4 120 pmol kg-l min-l and Ra2 =
l l

ners Burns Institute, 815 Market St., Galveston, TX 77550.

100 kmol. kg-l minl, which are both significantly
l lower Received 6 August 1993; accepted in final form 22 February 1994.
than the pyruvate production rate, which is 308 prnol
-l.min-
kg 4 Equations 30 and 31 significantly underesti- REFERENCES
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This work was supported in part by National Institute of Diabetes 21. Rosenblatt, J., D. L. Chinkes, M. Wolfe, and R. R. Wolfe.
and Digestive and Kidnev Diseases Grant DK-38010 and Shriner’s Stable isotope tracer analysis by GC-MS, including quantification

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Copyright © 1994 American Physiological Society. All rights reserved.
El82 PYRUVATE AND LACTATE KINETICS ACROSS HINDLIMB AND GUT

of isotopomer effects. Am. J. PhysioZ. 263 (EndocrinoZ. Metab. 26): 26. Wolfe, R. R. Radioactive and Stable Isotope Tracers in Biomedi-
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Copyright © 1994 American Physiological Society. All rights reserved.