Serum glucose adjusted cut-off values for normal cerebrospinal fluid/serum glucose ratio: implications for clinical practice
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Harald Hegen
Abstract
Background: Calculation of the cerebrospinal fluid/serum glucose (CSF/SGlu) ratio is part of the routine CSF work-up, however, different cut-off values ranging from 0.3 to 0.5 have been suggested so far to distinguish physiological from pathological conditions. The objective of this study was to determine cut-off values for normal CSF/SGlu ratio dependent on serum glucose concentrations.
Methods: We screened our database for paired CSF and serum samples, which have been collected by lumbar puncture, were processed within 1 h after withdrawal, showed cell count <15/3, erythrocyte count <1500/3 and normal CSF total protein resulting in 1036 sample pairs. Glucose concentrations in CSF and serum were measured by enzymatic spectrophotometry.
Results: Median glucose concentration in CSF was approximately 60% of that in serum. CSF/SGlu ratios negatively correlated with serum glucose levels (R=–0.586, p<0.001) and cut-off values for normal CSF/SGlu ratio defined as the 5th percentile were 0.5 for patients with serum glucose concentrations <100 mg/dL, 0.4 for those with a glucose level of 100–149 mg/dL and 0.3 for serum glucose concentrations ≥150 mg/dL.
Conclusions: CSF/SGlu ratio inversely correlates with serum glucose concentrations in a non-linear manner. These findings suggest that cut-off values for normal CSF/SGlu ratio must be adjusted to serum glucose levels, probably explaining the considerably varying cut-offs that have been reported so far.
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
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©2014 by De Gruyter
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Articles in the same Issue
- Frontmatter
- Editorial
- Red blood cell distribution width (RDW) and human pathology. One size fits all
- Reviews
- LC-MS candidate reference methods for the harmonisation of parathyroid hormone (PTH) measurement: a review of recent developments and future considerations
- C-reactive protein and migraine. Facts or speculations?
- Mini Review
- ABO blood group and von Willebrand factor: biological implications
- Genetics and Molecular Diagnostics
- Lactase persistence genotyping: rapid detection of seven sequence variants in a single tube with melting curve analyses
- General Clinical Chemistry and Laboratory Medicine
- The 3rd International Standard for serum IgE: international collaborative study to evaluate a candidate preparation
- Improving CardioCheck PA analytical performance: three-year study
- Serum copeptin level predicts a rapid decrease of overhydration after kidney transplantation
- Thyroid function and thyroid autoimmunity in apparently healthy pregnant and non-pregnant Mexican women
- Serum and follicular fluid fetuin-A in women undergoing in vitro fertilization
- Value of reelin for assessing hepatic fibrogenesis in a group of Egyptian HCV infected patients
- IgA anticardiolipin and IgA anti-β2 glycoprotein I antibody positivity determined by fluorescence enzyme immunoassay in primary antiphospholipid syndrome
- Reference Values and Biological Variations
- Serum glucose adjusted cut-off values for normal cerebrospinal fluid/serum glucose ratio: implications for clinical practice
- Age- and gender-specific brain natriuretic peptide (BNP) reference ranges in primary care
- Cancer Diagnostics
- Clinical utility of %p2PSA and prostate health index in the detection of prostate cancer
- Clinical prognostic value of CD4+CD25+FOXP3+regulatory T cells in peripheral blood of Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma patients
- Increased expression of carbonic anhydrase IX in oral submucous fibrosis and oral squamous cell carcinoma
- Cardiovascular Diseases
- Ideal cardiovascular health behaviors and factors and high sensitivity C-reactive protein: the Kailuan cross-sectional study in Chinese
- Letters to the Editor
- Red cell distribution width predicts chronic thromboembolic pulmonary hypertension in patients with acute pulmonary embolism in a long-term follow-up
- Red blood cell distribution width is significantly associated with aging and gender
- Red blood cell distribution width: a potential prognostic index for liver disease?
- Serum folate and vitamin B12: does light really matter?
- Thalassemia diagnosis in a blood donor from a unique trimorphic red blood cell population observed in the recipient
- A preliminary study on serum proteomics in fibromyalgia syndrome
- First study of angiotensin converting enzyme in cystic fibrosis Tunisian patients
- FlashFISH™: a novel technique for rapid diagnosis of aneuploidies in dysmorphic neonates
- Determination of the amniotic fluid lecithin/sphingomyelin ratio using a pipette tip column with a cation-exchange resin and mass spectrometry
- Congress Abstracts
- 57th National Congress of the Hungarian Society of Laboratory Medicine
