Does Diabetes Alter CSF Total Protein Levels? A Retrospective Cohort Study

Area of Science:

• Neurology
• Endocrinology
• Clinical Chemistry

Background:

• Clinicians often overlook elevated cerebrospinal fluid total protein (CSF-TP) in diabetic patients.
• Previous research on diabetes and CSF-TP has significant limitations.
• A large-scale analysis is needed to clarify the relationship between diabetes and CSF-TP.

Purpose of the Study:

• To investigate the association between diabetes and CSF-TP.
• To analyze a large database of CSF samples to determine if diabetes influences CSF-TP levels.
• To address the limitations of prior studies on this topic.

Main Methods:

• A retrospective review of diagnostic lumbar punctures performed between 1996 and 2016.
• Exclusion of patients with elevated CSF cell counts or conditions known to increase CSF-TP.
• Multivariate linear regression analysis to assess the impact of age, sex, and diabetes on CSF-TP.

Main Results:

• Analysis included 6124 patients, with 746 having diabetes.
• Mean CSF-TP was comparable between diabetic (0.39 mmol/L) and non-diabetic (0.35 mmol/L) groups (p = 0.2).
• Multivariate analysis revealed no significant effect of diabetes on CSF-TP after controlling for age and sex, nor a significant correlation with serum glucose.

Conclusions:

• Diabetes does not significantly alter CSF-TP levels when age and sex are considered.
• Elevated CSF-TP should be interpreted as pathological, irrespective of a patient's diabetic status.
• This study underscores the importance of evaluating CSF-TP as a potential indicator of pathology in all patients.