Measurement of lactate levels in serum and bile using proton nuclear magnetic resonance in patients with hepatobiliary diseases: its utility in detection of malignancies

Abstract

Proton nuclear magnetic resonance (1H-NMR) has been utilized for qualitative and quantitative measurement of the components of nonhomogeneous biological specimens, as it can analyze sensitively the chemical structure of organic compounds without pretreatment of the materials. Levels of lactate in serum and bile were measured by 1H-NMR in healthy volunteers and patients with non-malignant or malignant diseases of the liver and biliary tract, and the usefulness of such measurements for the diagnosis of hepatobiliary malignancies was determined. The mean (+/- SD) serum lactate levels were 0.52 +/- 0.33 mmol/l in five healthy volunteers, 1.38 +/- 1.59 mmol/l in 30 patients with non-malignant diseases and 2.95 +/- 2.00 mmol/l in 21 patients with malignant diseases, the differences among the three groups being significant. Biochemical enzymatic measurement of serum lactate levels revealed no such difference. In bile, the spectrum of lactate was observed in all of 16 patients with malignant diseases, but in none of two healthy volunteers and 12 patients with non-malignant diseases. The mean time required for the measurement was 36.77 min for serum and 6.40 min for bile. The measurement of lactate levels in serum and bile using 1H-NMR may be useful for the detection of hepatobiliary malignancies.

Feasibility of Identifying Pancreatic Cancer Based on Serum Metabolomics

“…Hyperinsulinemia and peripheral insulin resistance are typical in pancreatic cancer, whereas chronic pancreatitis (which also may be associated with a pancreatic mass) is accompanied by islet cell destruction and impaired insulin production (29,30). Serum lactate levels tend to be higher in patients with periampullary malignancies than healthy controls and patients with benign periampullary lesions (31). In animal models of pancreatic cancer (32), metabolomic profiles associated with disease progression have been demonstrated.…”

“…In animal models of pancreatic cancer (32), metabolomic profiles associated with disease progression have been demonstrated. Others have reported that the metabolomic profile of bile can discriminate benign and malignant strictures (31,33). However, bile is generally inconvenient to sample.…”

Simultaneous quantification of glycine- and taurine-conjugated bile acids, total bile acids, and choline-containing phospholipids in human bile using 1H NMR spectroscopy

“…The composition of bile is altered in various chronic cholestatic diseases [2][3][4][5][6][7][8]. The ratio of taurine to glycine conjugated bile acids is especially altered and it has been reported that the taurine conjugates are elevated in cholestatic conditions [9].…”

Current and future applications ofin vitromagnetic resonance spectroscopy in hepatobiliary disease

“…This preliminary observation was confirmed by significant differences in the peak area ratios of PTC, referenced to the TSP standard in the 1 H MR spectra (P = 0.007) [68] . Nishijima and colleagues have observed a lactate peak in bile spectra from patients with hepatic and biliary malignancy but not in bile from patients with nonmalignant disease or bile from healthy controls [73] . The significance of this finding has yet to be determined in larger studies, where the collection and storage of bile for analysis are performed according to uniform protocols without potential contamination from ERCP contrast agents or the uncertainty of a long storage time that may lead to lactate accumulation.…”