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Lactate Stress Testing in 155 Patients with Mitochondriopathy

Published online by Cambridge University Press:  02 December 2014

Josef Finsterer  and
Erika Milvay
Josef Finsterer
Affiliation:
Ludwig Boltzmann Institute for Research in Neuromuscular Disorders, Vienna, Austria, Europe
Erika Milvay
Affiliation:
Ludwig Boltzmann Institute for Research in Neuromuscular Disorders, Vienna, Austria, Europe
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Abstract

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Objective:

Few data are available about the diagnostic yield of the lactate stress test (LST) in a large group of patients with mitochondriopathy (MCP).

Methods:

Serum lactate was determined once before, three times during, and once after a 15-minute, constant 30W workload on a bicycle in 62 controls, aged 17 to 84 years, 155 patients with MCP, aged 17 to 87 years, and 31 patients with neurological disorders other than MCP.

Results:

Lactate's upper reference limits at rest, 5, 10, 15 minutes after starting, and 15 minutes after finishing the exercise were 2.0, 2.1, 2.1, 2.1 and 1.8 mmol/l respectively. The test was regarded abnormal if more than two of the five lactate values exceeded the cut-off levels. Among the 103 patients with abnormal LST, 64 (62 %) had normal resting lactate. The sensitivity of the test was 67% and the specificity 94%.

Conclusion:

The LST proved to have a high sensitivity and specificity in the detection of patients with MCP, being thus a simple but powerful tool to assess the impaired oxidative metabolism in MCP patients.

Résumé:

RÉSUMÉ:Objectif:

Il y a peu de données disponibles sur la valeur diagnostique du test du lactate à l'effort (TLE) chez un groupe important de patients atteints de mitochondriopathie (MCP).

Méthodes:

Le taux de lactate sérique a été déterminé avant, à trois reprises pendant et après un e activité physique de 15 minutes, d'intensité constante à 30W sur une bicyclette, chez 62 contrôles âgés de 17 à 84 ans, 155 patients atteints de MCP, âgés de 17 à 87 ans et 31 patients présentant d'autres pathologies neurologiques.

Résultats:

Le point de coupe supérieur des valeurs de référence au repos, 5, 10, 15 minutes après le début de l'exercice et 15 minutes après la fin de l'exercice étaient de 2,0, 2,1, 2,1, 2,1 et 1,8 mmol/L respectivement. Le test était considéré comme normal si plus de deux des cinq valeurs de lactate étaient supérieures au point de coupe. Parmi les 103 patients dont le TLE était anormal, 64 (62%) avaient un taux de lactate normal au repos. La sensibilité du test était de 67% et la spécificité de 94%.

Conclusion:

Le TLE a démontré une sensibilité et une spécificité élevées pour la détection de patients porteurs d'une MCP. C'est un outil simple mais puissant pour évaluer l'altération du métabolisme oxydatif chez les patients atteints de MCP.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 1 , February 2002 , pp. 49 - 53
Copyright
Copyright © Canadian Neurological Sciences Federation 2002

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