Pyruvic acid supplies energy to living cells. In anaerobic condutions (lacking oxygen), it is the end product converted to lactic acid, but in aerobic condutions (with oxygen) it is metabolised further to produce CO2 and H2O to synthesize more energy for the organism. This is called the Krebs Cycle. It is a key intersection in the network of metabolic pathways. Pyruvate can be converted to carbohydrates via gluconeogenesis, to fatty acids or energy pathways through Acetyl CoA or to the amino acid alanine and to ethanol.
Interpretation: The lactate:pyruvate ( L:P ) ratio is elevated in some mitochondrial (Energy supplying cell organelle). Many mitochondrial disorders have neurologic and myopathic features and may involve multiple organ systems. Determination of L:P ratio in Cerebrospinal fluid is helpful in neurologic disorders especially when the blood lactate levels are normal. In inherited disorders, a L:P ratio may point out Pyruvate Dehydrogenase enzyme deficiency which appear as lactic acidosis, ataxia and neuropathy, delayed development and hypotonia, congenital brain malformations, degenerative changes like Leigh’s Disease and facial dysmorphism. A low L:P ratio is usually ininterpretable.
Sample: Arm vein blood. Nonfasting
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