Exercise gluconeogenesis

Lactate consumption The direction of the lactate dehydrogenase reaction depends on the relative intracellular concentrations of pyruvate and lactate, and on the ratio of NADH/NAD+ in the cell. For example, in liver and heart, the ratio of NADH/NAD+ is lower than in exercising muscle. These tissues oxidize lactate (obtained from the blood) to pyruvate. In the liver, pyruvate is either converted to glucose by gluconeogenesis or oxidized in the TCA cycle. Heart muscle exclusively oxidizes lactate to CO2 and H20 via the citric acid cycle. 

Answer The first step in the synthesis of glucose from lactate in the liver is oxidation of the lactate to pyruvate like the oxidation of ethanol to acetaldehyde, this requires NAD+. Consumption of alcohol forces a competition for NAD+ between ethanol metabolism and gluconeogenesis, reducing the conversion of lactate to glucose and resulting in hypoglycemia. The problem is compounded by strenuous exercise and lack of food because at these times the level of blood glucose is already low. 

The mechanism that produces increased amino acid oxidation during exercise is unknown. White and Brooks (29) demonstrated a relationship of amino acid oxidation to use oT blood glucose. Concomitant with increases in the intensity of exercise and leucine oxidation, the oxidation of glucose and alanine increased. These data in combination with the earlier reports of increased flux of leucine to skeletal muscles and alanine from muscles to the liver suggest that the oxidation of amino acids may be linked to the need for glucose and to generation of substrates for gluconeogenesis. 

The different fuels used by exercising muscle are discussed in subsequent sections. These fuels may be arranged in the following "hierarchy," where the order of appearance approximates relative importance during exercise (1) creatine phosphate, (2) muscle and liver glycogen, (3) gluconeogenesis, and (4) fatty acids. 

Net breakdown of muscle can occur with either exercise or prolonged fasting. The mechanisms that control the breakdown of the various types of protein found in muscle are not well understood. It has, however, been established that while the branched-chain amino acids (BCAAs) released tend to be oxidized for energy in the muscle cell, other released amino acids enter the bloodstream for catabolism, and perhaps gluconeogenesis, in the liver Examination of the amino acids released from skeletal muscle reveals an apparent anomaly alanine accounts for or ly about 6% of the amino acids of muscle, but for about 35% of the amino acids released from muscle during exerdse. 

---