Lactate in the Gut
Condition: Lactate; Healthy; Hyperlactatemia
MeSH terms: Hyperlactatemia
Study type: Interventional

Summary: 
      Lactate is formed naturally in the body in example during physical activity. However, lactate
      is also formed during food fermentation where certain bacterial strains form lactate. Lactate
      can also be produced chemically. An example of this is Ringer-lactate which is used for
      volume replacement when treating dehydrated patients.

      As a source of carbon-molecules, lactate is believed to be an important oxidative fuel source
      in all major organs and yields adenosine triphosphate (ATP) production through Krebs cycle,
      the Electron Transport Chain in the mitochondria as well as by being a key precursor for
      gluconeogenesis.

      Metformin is the first drug of choice for type 2 diabetes treatment. Use of metformin often
      results in a small but significant weight loss in overweight users. It is known that
      metformin increases the lactate concentration in the gut. It is also known also know that
      metformin use is associated with an increase in blood concentrations of growth
      differentiation factor 15 (GDF-15). Receptors for GDF-15 can be found in parts of the brain
      associated with control of appetite. In rats increases in [GDF-15] results in a decrease in
      appetite and thus weight loss. GDF-15 is thought to be involved in the normal energy
      homeostasis.

      With this study the investigators want to examine the hormonal, metabolic and mechanical
      effects of lactate in the gut in healthy volunteers. Our hypothesis is that lactate has
      beneficial effects which may be though an increase in GDF-15 in the blood.

      Volunteers will undergo two study days separated by at least 7 days and a maximum of 1 month.

        -  On day one volunteers will drink a sodium-lactate solution (intervention). The
           investigators will also administrate 1500mg paracetamol to assess gastric emptying and
           do blood samples over 4 hours. The investigators measure [lactate] every 15 min. Every
           hour the investigators will ask volunteers questions regarding hunger and thoughts of
           future food intake (questionnaire). After 4 hours of blood sampling the investigators
           will serve volunteers an all-you-can-eat meal of sandwich and measure how must they ate.

        -  On day two volunteers will drink a sodium chloride solution. Furthermore, the
           investigators administrate intravenous D/L sodium lactate in order to reach the same
           plasma [lactate] on day 2 as was done on day 1. The rest of day two is identical to day
           1.
    


Intervention name(s): Oral Sodium Lactate; Intravenous sodium lactate
Intervention type(s): Drug; Drug
Intervention description(s): 25 grams of D/L lactate dissolved in 300mL water.; intravenous sodium lactate + oral sodium-chlorid solution
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: lactate; metabolism; Gastric emptying; GDF-15; insulin; incretin hormones