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Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice
Wilhelmina G Leen1, Michèl A Willemsen, Ron A Wevers
1Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, The Netherlands. w.leen@neuro.umcn.nl
Plos One
|August 11, 2012
Summary
This study establishes age-specific reference ranges for cerebrospinal fluid (CSF) glucose, CSF/plasma glucose ratio, and CSF lactate. These new ranges aid in accurately diagnosing neurological disorders in clinical practice.
Area of Science:
- Neurology
- Clinical Chemistry
- Biochemistry
Background:
- Cerebrospinal fluid (CSF) analysis is crucial for diagnosing neurological disorders.
- Established reference ranges for CSF glucose, CSF/plasma glucose ratio, and CSF lactate from large sample studies are lacking.
- Accurate reference values are essential for reliable clinical interpretation.
Purpose of the Study:
- To define age-specific reference values for CSF glucose, CSF/plasma glucose ratio, and CSF lactate.
- To provide a reliable basis for interpreting CSF analysis results in clinical practice.
- To investigate the relationship between blood glucose levels and CSF/plasma glucose ratio.
Main Methods:
- Analysis of 9,036 CSF samples collected between 1993 and 2008.
- Exclusion of samples with abnormal erythrocyte count, leukocyte count, bilirubin, free hemoglobin, or total protein.
- Determination of age-specific 5th-95th percentile ranges for CSF glucose (n=8,871), CSF/plasma glucose ratio (n=4,516), and CSF lactate (n=7,614).
Main Results:
- CSF glucose, CSF/plasma glucose ratio, and CSF lactate values showed age-dependency but not sex-dependency.
- Reference ranges were widest in neonates and narrowest in toddlers, with values increasing with age.
- Hypoglycemia correlated with an increased CSF/plasma glucose ratio, while hyperglycemia did not influence it.
Conclusions:
- Established age-specific reference ranges for CSF glucose, CSF/plasma glucose ratio, and CSF lactate.
- These reference values enhance the reliability of CSF analysis interpretation in clinical settings.
- The findings contribute to improved diagnostic accuracy for neurological conditions.
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