Attenuated hepatosplanchnic uptake of lactate during intense exercise in humans

We evaluated whether the increase in blood lactate with intense exercise is influenced by a low hepatosplanchnic blood flow as assessed by indocyanine green dye elimination and blood sampling from an artery and the hepatic vein in eight men. The hepatosplanchnic blood flow decreased from a resting value of 1.6 ± 0.1 to 0.7 ± 0.1 (SE) l/min during exercise. Yet the hepatosplanchnic O2uptake increased from 67 ± 3 to 93 ± 13 ml/min, and the output of glucose increased from 1.1 ± 0.1 to 2.1 ± 0.3 mmol/min ( P < 0.05). Even at the lowest hepatosplanchnic venous hemoglobin O2 saturation during exercise of 6%, the average concentration of glucose in arterial blood was maintained close to the resting level (5.2 ± 0.2 vs. 5.5 ± 0.2 mmol/l), whereas the difference between arterial and hepatic venous blood glucose increased to a maximum of 22 mmol/l. In arterial blood, the concentration of lactate increased from 1.1 ± 0.2 to 6.0 ± 1.0 mmol/l, and the hepatosplanchnic uptake of lactate was elevated from 0.4 ± 0.06 to 1.0 ± 0.05 mmol/min during exercise ( P < 0.05). However, when the hepatosplanchnic venous hemoglobin O2 saturation became low, the arterial and hepatosplanchnic venous blood lactate difference approached zero. Even with a marked reduction in its blood flow, exercise did not challenge the ability of the liver to maintain blood glucose homeostasis. However, it appeared that the contribution of the Cori cycle decreased, and the accumulation of lactate in blood became influenced by the reduced hepatosplanchnic blood flow.