Cerebrospinal fluid:serum glucose ratio in the ventricular and lumbar compartments: implications for clinical practice
Background and purpose Calculation of the cerebrospinal fluid:serum glucose (CSF:SGlu) ratio is part of the routine cerebrospinal fluid (CSF) work‐up. Reference values have been defined for lumbar CSF, but are lacking for ventricular CSF. The objective of this study was to investigate whether the CS...
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| Veröffentlicht in: | European journal of neurology 2018-02, Vol.25 (2), p.373-379 |
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| creator | Hegen, H. Walde, J. Auer, M. Deisenhammer, F. |
| description | Background and purpose
Calculation of the cerebrospinal fluid:serum glucose (CSF:SGlu) ratio is part of the routine cerebrospinal fluid (CSF) work‐up. Reference values have been defined for lumbar CSF, but are lacking for ventricular CSF. The objective of this study was to investigate whether the CSF:SGlu ratio is similar in lumbar and ventricular compartments, and to determine cut‐off values for CSF:SGlu ratio in ventricular CSF.
Methods
We included CSF samples that were collected by either lumbar puncture or ventricular drainage, with a red blood cell count |
| doi_str_mv | 10.1111/ene.13513 |
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Calculation of the cerebrospinal fluid:serum glucose (CSF:SGlu) ratio is part of the routine cerebrospinal fluid (CSF) work‐up. Reference values have been defined for lumbar CSF, but are lacking for ventricular CSF. The objective of this study was to investigate whether the CSF:SGlu ratio is similar in lumbar and ventricular compartments, and to determine cut‐off values for CSF:SGlu ratio in ventricular CSF.
Methods
We included CSF samples that were collected by either lumbar puncture or ventricular drainage, with a red blood cell count <500/μL, normal white blood cell count and age‐related normal total protein content, with simultaneously withdrawn serum sample and time to laboratory processing of ≤2 h. This resulted in 1808 sample pairs. Glucose concentrations in CSF and serum were measured by enzymatic spectrophotometry.
Results
The CSF:SGlu ratio was similar in ventricular and lumbar compartments after controlling for age, sex, time between sample withdrawal and laboratory processing, CSF white blood cell and red blood cell count, CSF total protein and serum glucose concentration using a multiple linear regression model. Lower limits for CSF:SGlu ratio in the ventricular compartment, defined as 5th percentile, were 0.51 for patients with serum glucose concentration < 100 mg/dL, 0.45 for those with serum glucose concentration ≥ 100 mg/dL and <150 mg/dL, and 0.36 for those with serum glucose concentration ≥150 mg/dL.
Conclusions
The CSF:SGlu ratio was similar in the ventricular and lumbar compartments, and depended mainly on time to laboratory processing and absolute serum glucose levels. Previously established lower limits for CSF:SGlu ratio in lumbar CSF can be also applied for ventricular CSF.</description><identifier>ISSN: 1351-5101</identifier><identifier>EISSN: 1468-1331</identifier><identifier>DOI: 10.1111/ene.13513</identifier><identifier>PMID: 29115000</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Adult ; Age ; Aged ; Aged, 80 and over ; Blood ; Blood Glucose - metabolism ; Cerebral Ventricles ; Cerebrospinal fluid ; Cerebrospinal Fluid - metabolism ; Compartments ; Erythrocytes ; Female ; Glucose ; Glucose - cerebrospinal fluid ; Humans ; Laboratories ; Leukocytes ; lumbar ; Male ; Middle Aged ; ratio ; Reference Values ; Regression models ; Sampling methods ; serum ; Spectrophotometry ; Spinal Cord ; Spinal Puncture ; Ventricle ; ventricular ; Young Adult</subject><ispartof>European journal of neurology, 2018-02, Vol.25 (2), p.373-379</ispartof><rights>2017 EAN</rights><rights>2017 EAN.</rights><rights>Copyright © 2018 European Academy of Neurology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3533-ced944c38732baff19a355b12037a90160bebb79de28f9dc8111f0a103c8e55c3</citedby><cites>FETCH-LOGICAL-c3533-ced944c38732baff19a355b12037a90160bebb79de28f9dc8111f0a103c8e55c3</cites><orcidid>0000-0002-2833-6337</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fene.13513$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fene.13513$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29115000$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hegen, H.</creatorcontrib><creatorcontrib>Walde, J.</creatorcontrib><creatorcontrib>Auer, M.</creatorcontrib><creatorcontrib>Deisenhammer, F.</creatorcontrib><title>Cerebrospinal fluid:serum glucose ratio in the ventricular and lumbar compartments: implications for clinical practice</title><title>European journal of neurology</title><addtitle>Eur J Neurol</addtitle><description>Background and purpose
Calculation of the cerebrospinal fluid:serum glucose (CSF:SGlu) ratio is part of the routine cerebrospinal fluid (CSF) work‐up. Reference values have been defined for lumbar CSF, but are lacking for ventricular CSF. The objective of this study was to investigate whether the CSF:SGlu ratio is similar in lumbar and ventricular compartments, and to determine cut‐off values for CSF:SGlu ratio in ventricular CSF.
Methods
We included CSF samples that were collected by either lumbar puncture or ventricular drainage, with a red blood cell count <500/μL, normal white blood cell count and age‐related normal total protein content, with simultaneously withdrawn serum sample and time to laboratory processing of ≤2 h. This resulted in 1808 sample pairs. Glucose concentrations in CSF and serum were measured by enzymatic spectrophotometry.
Results
The CSF:SGlu ratio was similar in ventricular and lumbar compartments after controlling for age, sex, time between sample withdrawal and laboratory processing, CSF white blood cell and red blood cell count, CSF total protein and serum glucose concentration using a multiple linear regression model. Lower limits for CSF:SGlu ratio in the ventricular compartment, defined as 5th percentile, were 0.51 for patients with serum glucose concentration < 100 mg/dL, 0.45 for those with serum glucose concentration ≥ 100 mg/dL and <150 mg/dL, and 0.36 for those with serum glucose concentration ≥150 mg/dL.
Conclusions
The CSF:SGlu ratio was similar in the ventricular and lumbar compartments, and depended mainly on time to laboratory processing and absolute serum glucose levels. Previously established lower limits for CSF:SGlu ratio in lumbar CSF can be also applied for ventricular CSF.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood</subject><subject>Blood Glucose - metabolism</subject><subject>Cerebral Ventricles</subject><subject>Cerebrospinal fluid</subject><subject>Cerebrospinal Fluid - metabolism</subject><subject>Compartments</subject><subject>Erythrocytes</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose - cerebrospinal fluid</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Leukocytes</subject><subject>lumbar</subject><subject>Male</subject><subject>Middle Aged</subject><subject>ratio</subject><subject>Reference Values</subject><subject>Regression models</subject><subject>Sampling methods</subject><subject>serum</subject><subject>Spectrophotometry</subject><subject>Spinal Cord</subject><subject>Spinal Puncture</subject><subject>Ventricle</subject><subject>ventricular</subject><subject>Young Adult</subject><issn>1351-5101</issn><issn>1468-1331</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kbtOxDAQRS0E4l3wA8gSDRRhPfE6a9Oh1fKQEDRQR44zASPngR2D9u_xskCBxDQznjm-xb2EHAE7h1QT7PAcuAC-QXZhWsgMOIfNNKddJoDBDtkL4ZUxls9ytk12cgUg0nOXvM_RY-X7MNhOO9q4aOuLgD629NlF0wekXo-2p7aj4wvSd-xGb0102lPd1dTFtkqj6dtB-7FN13BBbTs4a1bfukCbPp2d7dLC0cFrM1qDB2Sr0S7g4XffJ09Xi8f5TXb3cH07v7zLDBecZwZrNZ0aLmc8r3TTgNJciApyxmdaMShYhVU1UzXmslG1kcmNhmlg3EgUwvB9crrWHXz_FjGMZWuDQed0h30MJagCZMGkVAk9-YO-9tEnU1aUVEIwWchEna0pkzwLHpty8LbVflkCK1dhlCmM8iuMxB5_K8aqxfqX_HE_AZM18GEdLv9XKhf3i7XkJ5tolK4</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Hegen, H.</creator><creator>Walde, J.</creator><creator>Auer, M.</creator><creator>Deisenhammer, F.</creator><general>John Wiley & Sons, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2833-6337</orcidid></search><sort><creationdate>201802</creationdate><title>Cerebrospinal fluid:serum glucose ratio in the ventricular and lumbar compartments: implications for clinical practice</title><author>Hegen, H. ; Walde, J. ; Auer, M. ; Deisenhammer, F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3533-ced944c38732baff19a355b12037a90160bebb79de28f9dc8111f0a103c8e55c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood</topic><topic>Blood Glucose - metabolism</topic><topic>Cerebral Ventricles</topic><topic>Cerebrospinal fluid</topic><topic>Cerebrospinal Fluid - metabolism</topic><topic>Compartments</topic><topic>Erythrocytes</topic><topic>Female</topic><topic>Glucose</topic><topic>Glucose - cerebrospinal fluid</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Leukocytes</topic><topic>lumbar</topic><topic>Male</topic><topic>Middle Aged</topic><topic>ratio</topic><topic>Reference Values</topic><topic>Regression models</topic><topic>Sampling methods</topic><topic>serum</topic><topic>Spectrophotometry</topic><topic>Spinal Cord</topic><topic>Spinal Puncture</topic><topic>Ventricle</topic><topic>ventricular</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hegen, H.</creatorcontrib><creatorcontrib>Walde, J.</creatorcontrib><creatorcontrib>Auer, M.</creatorcontrib><creatorcontrib>Deisenhammer, F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hegen, H.</au><au>Walde, J.</au><au>Auer, M.</au><au>Deisenhammer, F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebrospinal fluid:serum glucose ratio in the ventricular and lumbar compartments: implications for clinical practice</atitle><jtitle>European journal of neurology</jtitle><addtitle>Eur J Neurol</addtitle><date>2018-02</date><risdate>2018</risdate><volume>25</volume><issue>2</issue><spage>373</spage><epage>379</epage><pages>373-379</pages><issn>1351-5101</issn><eissn>1468-1331</eissn><abstract>Background and purpose
Calculation of the cerebrospinal fluid:serum glucose (CSF:SGlu) ratio is part of the routine cerebrospinal fluid (CSF) work‐up. Reference values have been defined for lumbar CSF, but are lacking for ventricular CSF. The objective of this study was to investigate whether the CSF:SGlu ratio is similar in lumbar and ventricular compartments, and to determine cut‐off values for CSF:SGlu ratio in ventricular CSF.
Methods
We included CSF samples that were collected by either lumbar puncture or ventricular drainage, with a red blood cell count <500/μL, normal white blood cell count and age‐related normal total protein content, with simultaneously withdrawn serum sample and time to laboratory processing of ≤2 h. This resulted in 1808 sample pairs. Glucose concentrations in CSF and serum were measured by enzymatic spectrophotometry.
Results
The CSF:SGlu ratio was similar in ventricular and lumbar compartments after controlling for age, sex, time between sample withdrawal and laboratory processing, CSF white blood cell and red blood cell count, CSF total protein and serum glucose concentration using a multiple linear regression model. Lower limits for CSF:SGlu ratio in the ventricular compartment, defined as 5th percentile, were 0.51 for patients with serum glucose concentration < 100 mg/dL, 0.45 for those with serum glucose concentration ≥ 100 mg/dL and <150 mg/dL, and 0.36 for those with serum glucose concentration ≥150 mg/dL.
Conclusions
The CSF:SGlu ratio was similar in the ventricular and lumbar compartments, and depended mainly on time to laboratory processing and absolute serum glucose levels. Previously established lower limits for CSF:SGlu ratio in lumbar CSF can be also applied for ventricular CSF.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>29115000</pmid><doi>10.1111/ene.13513</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2833-6337</orcidid></addata></record> |
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| subjects | Adult Age Aged Aged, 80 and over Blood Blood Glucose - metabolism Cerebral Ventricles Cerebrospinal fluid Cerebrospinal Fluid - metabolism Compartments Erythrocytes Female Glucose Glucose - cerebrospinal fluid Humans Laboratories Leukocytes lumbar Male Middle Aged ratio Reference Values Regression models Sampling methods serum Spectrophotometry Spinal Cord Spinal Puncture Ventricle ventricular Young Adult |
| title | Cerebrospinal fluid:serum glucose ratio in the ventricular and lumbar compartments: implications for clinical practice |
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