However, the conversion of lactate to glucose requires the expenditure of 6 ATP equivalents by the liver: 2 lactate 2NAD 2 pyruvate 2NADH 2 pyruvate 2ATP 2CO2 2 oxaloacetate 2ADP 2Pi 2 oxaloacetate 2GTP 2PEP 2GDP 2Pi 2CO2 2PEP 2ATP 2NADH glucose 2ADP 2Pi 2NAD Net: 2 lactate 4ATP 2GTP 4ADP 2GDP 6Pi Each mole of glucose that goes through the Cori cycle costs the liver 6 ATP equivalents. If the Cori cycle were perfect and there were an endless supply of ATP, liver could supply glucose equivalents forever just using the same carbon atoms (6 in as lactate, 6 out as glucose). However, some of the lactate (pyruvate) in the nonliver tissues is burned to CO2 by the TCA cycle in the muscle and other tissues. It s this pool that must be replaced by fresh glucose from liver.
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