Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.

Cerebrospinal fluid (CSF) analysis is an important tool in the diagnostic work-up of many neurological disorders, but reference ranges for CSF glucose, CSF/plasma glucose ratio and CSF lactate based on studies with large numbers of CSF samples are not available. Our aim was to define age-specific re...

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Autores principales:	Wilhelmina G Leen, Michèl A Willemsen, Ron A Wevers, Marcel M Verbeek
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/31dc04bddc6d48f193a9b61e475968a4
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spelling	oai:doaj.org-article:31dc04bddc6d48f193a9b61e475968a42021-11-18T07:09:32ZCerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.1932-620310.1371/journal.pone.0042745https://doaj.org/article/31dc04bddc6d48f193a9b61e475968a42012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22880096/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203Cerebrospinal fluid (CSF) analysis is an important tool in the diagnostic work-up of many neurological disorders, but reference ranges for CSF glucose, CSF/plasma glucose ratio and CSF lactate based on studies with large numbers of CSF samples are not available. Our aim was to define age-specific reference values. In 1993 The Nijmegen Observational CSF Study was started. Results of all CSF samples that were analyzed between 1993 and 2008 at our laboratory were systematically collected and stored in our computerized database. After exclusion of CSF samples with an unknown or elevated erythrocyte count, an elevated leucocyte count, elevated concentrations of bilirubin, free hemoglobin, or total protein 9,036 CSF samples were further studied for CSF glucose (n = 8,871), CSF/plasma glucose ratio (n = 4,516) and CSF lactate values (n = 7,614). CSF glucose, CSF/plasma glucose ratio and CSF lactate were age-, but not sex dependent. Age-specific reference ranges were defined as 5-95(th) percentile ranges. CSF glucose 5(th) percentile values ranged from 1.8 to 2.9 mmol/L and 95(th) percentile values from 3.8 to 5.6 mmol/L. CSF/plasma glucose ratio 5(th) percentile values ranged from 0.41 to 0.53 and 95(th) percentile values from 0.82 to 1.19. CSF lactate 5(th) percentile values ranged from 0.88 to 1.41 mmol/L and 95(th) percentile values from 2.00 to 2.71 mmol/L. Reference ranges for all three parameters were widest in neonates and narrowest in toddlers, with lower and upper limits increasing with age. These reference values allow a reliable interpretation of CSF results in everyday clinical practice. Furthermore, hypoglycemia was associated with an increased CSF/plasma glucose ratio, whereas hyperglycemia did not affect the CSF/plasma glucose ratio.Wilhelmina G LeenMichèl A WillemsenRon A WeversMarcel M VerbeekPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e42745 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Wilhelmina G Leen Michèl A Willemsen Ron A Wevers Marcel M Verbeek Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.
description	Cerebrospinal fluid (CSF) analysis is an important tool in the diagnostic work-up of many neurological disorders, but reference ranges for CSF glucose, CSF/plasma glucose ratio and CSF lactate based on studies with large numbers of CSF samples are not available. Our aim was to define age-specific reference values. In 1993 The Nijmegen Observational CSF Study was started. Results of all CSF samples that were analyzed between 1993 and 2008 at our laboratory were systematically collected and stored in our computerized database. After exclusion of CSF samples with an unknown or elevated erythrocyte count, an elevated leucocyte count, elevated concentrations of bilirubin, free hemoglobin, or total protein 9,036 CSF samples were further studied for CSF glucose (n = 8,871), CSF/plasma glucose ratio (n = 4,516) and CSF lactate values (n = 7,614). CSF glucose, CSF/plasma glucose ratio and CSF lactate were age-, but not sex dependent. Age-specific reference ranges were defined as 5-95(th) percentile ranges. CSF glucose 5(th) percentile values ranged from 1.8 to 2.9 mmol/L and 95(th) percentile values from 3.8 to 5.6 mmol/L. CSF/plasma glucose ratio 5(th) percentile values ranged from 0.41 to 0.53 and 95(th) percentile values from 0.82 to 1.19. CSF lactate 5(th) percentile values ranged from 0.88 to 1.41 mmol/L and 95(th) percentile values from 2.00 to 2.71 mmol/L. Reference ranges for all three parameters were widest in neonates and narrowest in toddlers, with lower and upper limits increasing with age. These reference values allow a reliable interpretation of CSF results in everyday clinical practice. Furthermore, hypoglycemia was associated with an increased CSF/plasma glucose ratio, whereas hyperglycemia did not affect the CSF/plasma glucose ratio.
format	article
author	Wilhelmina G Leen Michèl A Willemsen Ron A Wevers Marcel M Verbeek
author_facet	Wilhelmina G Leen Michèl A Willemsen Ron A Wevers Marcel M Verbeek
author_sort	Wilhelmina G Leen
title	Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.
title_short	Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.
title_full	Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.
title_fullStr	Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.
title_full_unstemmed	Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.
title_sort	cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/31dc04bddc6d48f193a9b61e475968a4
work_keys_str_mv	AT wilhelminagleen cerebrospinalfluidglucoseandlactateagespecificreferencevaluesandimplicationsforclinicalpractice AT michelawillemsen cerebrospinalfluidglucoseandlactateagespecificreferencevaluesandimplicationsforclinicalpractice AT ronawevers cerebrospinalfluidglucoseandlactateagespecificreferencevaluesandimplicationsforclinicalpractice AT marcelmverbeek cerebrospinalfluidglucoseandlactateagespecificreferencevaluesandimplicationsforclinicalpractice
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Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.

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