• KSBNS 2024


Original Article

Exp Neurobiol 2020; 29(4): 314-322

Published online August 31, 2020

© The Korean Society for Brain and Neural Sciences

Higher Lactate Level and Lactate-to-Pyruvate Ratio in Autism Spectrum Disorder

Miae Oh1, Soon Ae Kim2 and Hee Jeong Yoo3,4*

1Department of Psychiatry, Kyung Hee University Hospital, Seoul 02447, 2Department of Pharmacology, School of Medicine, Eulji University, Daejon 34824, 3Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam 13620, 4Seoul National University College of Medicine, Seoul 08826, Korea

Correspondence to: *To whom correspondence should be addressed.
TEL: 82-31-787-7436, FAX: 82-31-787-4058

Received: July 15, 2020; Revised: August 31, 2020; Accepted: August 31, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License
( which permits unrestricted non-commercial use, distribution, and
reproduction in any medium, provided the original work is properly cited.

Mitochondrial dysfunction is considered one of the pathophysiological mechanisms of autism spectrum disorder (ASD). However, previous studies of biomarkers associated with mitochondrial dysfunction in ASD have revealed inconsistent results. The objective of this study was to evaluate biochemical markers associated with mitochondrial dysfunction in subjects with ASD and their unaffected family members. Lactate and pyruvate levels, as well as the lactate-to-pyruvate ratio, were examined in the peripheral blood of probands with ASD (Affected Group, AG) and their unaffected family members (biological parents and unaffected siblings, Unaffected Group, UG). Lactate ≥22 mg/dl, pyruvate ≥1.4 mg/dl, and lactate-topyruvate ratio >25 were defined as abnormal. The clinical variables were compared between subjects with higher (>25) and lower (≤25) lactate-topyruvate ratios within the AG. The AG (n=59) had a significantly higher lactate and lactate-to-pyruvate ratio than the UG (n=136). The frequency of subjects with abnormally high lactate levels and lactate-to-pyruvate ratio was significantly higher in the AG (lactate 31.0% vs. 9.5%, ratio 25.9% vs. 7.3%, p<0.01). The relationship between lactate level and the repetitive behavior domain of the Autism Diagnostic Interview-Revised was statistically significant. These results suggest that biochemical markers related to mitochondrial dysfunction, especially higher lactate levels and lactateto- pyruvate ratio, might be associated with the pathophysiology of ASD. Further larger studies using unrelated individuals are needed to control for the possible effects of age and sex on chemical biomarker levels.

Graphical Abstract

Keywords: Autism spectrum disorder, Lactate, Pyruvate, Lactate/pyruvate ratio