Lactate/Pyruvate Ratio
Optimal Result:
10 - 20 Ratio.
The blood lactate to pyruvate ratio is used to distinguish between pyruvate dehydrogenase deficiency and other causes of congenital lactic acidosis. In conjunction with an elevated lactate, an L:P ratio greater than 30 suggests inherited disorders of the respiratory chain complex or tricarboxylic acid cycle disorders. In conjunction with an elevated lactate, an L:P ratio less than 25 suggests a defect in pyruvate metabolism. An artificially high L:P ratio can be observed in acutely ill individuals. Abnormal concentrations of lactate, pyruvate, and the L:P ratio are not diagnostic for any single disorder and must be interpreted in the context of the individual's clinical presentation and other laboratory studies.
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What does it mean if your Lactate/Pyruvate Ratio result is too high?
The L:P ratio is elevated in several, but not all, mitochondrial respiratory chain disorders. Mitochondrial disorders vary widely in presentation and age of onset. Many mitochondrial disorders have neurologic and myopathic features and may involve multiple organ systems.
An elevated lactate-to-pyruvate (L:P) ratio may indicate inherited disorders of the respiratory chain complex, tricarboxylic acid cycle disorders and pyruvate carboxylase deficiency. Respiratory chain defects usually result in L:P ratios above 20.
An artifactually high ratio can be found if the patient is acutely ill.
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What does it mean if your Lactate/Pyruvate Ratio result is too low?
A low L:P ratio (disproportionately elevated pyruvic acid) may indicate an inherited disorder of pyruvate metabolism. Defects of the pyruvate dehydrogenase complex result in L:P ratios below 10.
A low L:P ratio is observed in inherited disorders of pyruvate metabolism including pyruvate dehydrogenase complex (PDHC) deficiency. Clinical presentation of PDHC deficiency can range from fatal congenital lactic acidosis to relatively mild ataxia or neuropathy. The most common features in infants and children with PDHC deficiency are delayed development and hypotonia. Seizures and ataxia are also frequent features. Other manifestations can include congenital brain malformations, degenerative changes including Leigh disease, and facial dysmorphism.
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