Pyruvate or pyruvic acid is an intermediate in several metabolic pathways including glycolysis, the citric acid cycle, fatty acid metabolism, and the mitochondrial electron transport chain. Abnormalities in pyruvate alone are not diagnostic of any disease, but they are clinically useful when measured with lactate deform the lactate to pyruvate ratio. The lactate to pyruvate ratio is elevated in most mitochondrial respiratory chain disorders. On the other hand, a low lactate to pyruvate ratio occurs in certain genetic conditions including pyruvate dehydrogenase complex deficiency. The lactate to pyruvate ratio is not necessarily diagnostic of any specific disorder. Ideally, lactate should be obtained from an arterial source, pyruvate can be obtained from venous blood.
Normal Ranges for pyruvate:
0.08-0.16 mmol/L
NIH Unit
0.7-1.4 mg/dL
Sources:
https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8657
https://www.healthcare.uiowa.edu/path_handbook/handbook/test1622.html
https://www.uptodate.com/contents/inborn-errors-of-metabolism-identifying-the-specific-disorder
Interpretation of a given pyruvate level is impossible without a corresponding lactate level. Low pyruvate in this context may correspond to a high lactate to pyruvate ratio. This may be seen in mitochondrial disorders and in pyruvate carboxylase deficiency.
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Interpretation of a given pyruvate level is impossible without a corresponding lactate level. High pyruvate in this context may correspond to a low lactate to pyruvate ratio. This may be seen in inherited disorders of pyruvate metabolism.
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