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Conference Paper: Re-exploring the cerebrospinal fluid (CSF) to serum glucose ratio.

TitleRe-exploring the cerebrospinal fluid (CSF) to serum glucose ratio.
Authors
Issue Date2003
PublisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org
Citation
Joint Annual Scientific Meeting of the Hong Kong Epilepsy Society and The Hong Kong Neurological Society, Hong Kong, 7-9 November 2003. In Hong Kong Medical Journal, 2003, v. 9 n. S2, p. 8 How to Cite?
AbstractBackground In interpretation of lumbar puncture (LP) findings, CSF glucose is conventionally expressed as a ratio to the simultaneous level in serum. A low ratio indicates hypoglycorrhachia and pathological conditions. Method We retrospectively studied the CSF findings in consecutive LPs performed in our ward over 5 years. Patients with conditions known to cause CSF hypoglycorrhacia, uncertain diagnosis and inadequate laboratory data were excluded. Blood for simultaneous serum glucose level was sampled within one hour of LP. ANOVA, Newman-Keuls multiple comparisons test and linear regression were used for statistical analysis. Results 170 sets of samples from patients with central demyelination (45), neuropathies (66), headache (26), normal pressure hydrocephalus (11), neurodegenerative diseases (8), and others conditions (14) were studied. CSF glucose was <2.2 mmol/L in only one sample. Mean CSF to serum glucose ratio was 0.61 (range 0.21-1.00). Proportion of samples with ratios of <0.50, 0.50-0.59, 0.60-0.69 and ≥0.70 were 18.8, 27.1, 29.4 and 24.7% for all patients, and 6.8, 27.3, 38.6 and 27.3%, 60.0, 24.0, 8.0 and 8.0%, or 61.5, 30.8, 0.0 and 7.7% for patients with simultaneous serum glucose of < 7.8, 7.8-11.1 or >11.1 mmol/L, respectively. Mean CSF to serum glucose ratios were significantly different between patients with simultaneous serum glucose of <7.8, 7.8-11.1 and >11.1 mmol/L (P <0.0001), but not for different neurological conditions (P = 0.5911). Linear regression showed a significant relation between serum and CSF glucose (r = 0.769, P <0.0001) and inverse correlation between serum glucose and CSF to serum glucose ratio (r = -0.569, P <0.0001, y = 0.8 - 0.03x). Conclusions Our study demonstrates the CSF to serum glucose ratio is not constantly related to but varies inversely with the simultaneous serum glucose level. A significant proportion of patients without conditions causing CSF hypoglycorrhachia has a low ratio during hyperglycaemia. The coefficient derived from our linear regression model can be applied for adjustment of such deviations.
Persistent Identifierhttp://hdl.handle.net/10722/101718
ISSN
2015 Impact Factor: 0.887
2015 SCImago Journal Rankings: 0.279

 

DC FieldValueLanguage
dc.contributor.authorCheng, TSen_HK
dc.contributor.authorMak, Wen_HK
dc.contributor.authorFong, CYen_HK
dc.contributor.authorTsang, KLen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorCheung, RTFen_HK
dc.contributor.authorHo, SLen_HK
dc.date.accessioned2010-09-25T20:01:03Z-
dc.date.available2010-09-25T20:01:03Z-
dc.date.issued2003en_HK
dc.identifier.citationJoint Annual Scientific Meeting of the Hong Kong Epilepsy Society and The Hong Kong Neurological Society, Hong Kong, 7-9 November 2003. In Hong Kong Medical Journal, 2003, v. 9 n. S2, p. 8en_HK
dc.identifier.issn1024-2708en_HK
dc.identifier.urihttp://hdl.handle.net/10722/101718-
dc.description.abstractBackground In interpretation of lumbar puncture (LP) findings, CSF glucose is conventionally expressed as a ratio to the simultaneous level in serum. A low ratio indicates hypoglycorrhachia and pathological conditions. Method We retrospectively studied the CSF findings in consecutive LPs performed in our ward over 5 years. Patients with conditions known to cause CSF hypoglycorrhacia, uncertain diagnosis and inadequate laboratory data were excluded. Blood for simultaneous serum glucose level was sampled within one hour of LP. ANOVA, Newman-Keuls multiple comparisons test and linear regression were used for statistical analysis. Results 170 sets of samples from patients with central demyelination (45), neuropathies (66), headache (26), normal pressure hydrocephalus (11), neurodegenerative diseases (8), and others conditions (14) were studied. CSF glucose was <2.2 mmol/L in only one sample. Mean CSF to serum glucose ratio was 0.61 (range 0.21-1.00). Proportion of samples with ratios of <0.50, 0.50-0.59, 0.60-0.69 and ≥0.70 were 18.8, 27.1, 29.4 and 24.7% for all patients, and 6.8, 27.3, 38.6 and 27.3%, 60.0, 24.0, 8.0 and 8.0%, or 61.5, 30.8, 0.0 and 7.7% for patients with simultaneous serum glucose of < 7.8, 7.8-11.1 or >11.1 mmol/L, respectively. Mean CSF to serum glucose ratios were significantly different between patients with simultaneous serum glucose of <7.8, 7.8-11.1 and >11.1 mmol/L (P <0.0001), but not for different neurological conditions (P = 0.5911). Linear regression showed a significant relation between serum and CSF glucose (r = 0.769, P <0.0001) and inverse correlation between serum glucose and CSF to serum glucose ratio (r = -0.569, P <0.0001, y = 0.8 - 0.03x). Conclusions Our study demonstrates the CSF to serum glucose ratio is not constantly related to but varies inversely with the simultaneous serum glucose level. A significant proportion of patients without conditions causing CSF hypoglycorrhachia has a low ratio during hyperglycaemia. The coefficient derived from our linear regression model can be applied for adjustment of such deviations.-
dc.languageengen_HK
dc.publisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.orgen_HK
dc.relation.ispartofHong Kong Medical Journalen_HK
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Medical Association.en_HK
dc.titleRe-exploring the cerebrospinal fluid (CSF) to serum glucose ratio.en_HK
dc.typeConference_Paperen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1024-2708&volume=9 &issue=Supplement&spage=8&epage=&date=2003&atitle=Re-exploring+the+cerebrospinal+fluid+(CSF)+to+serum+glucose+ratio.+en_HK
dc.identifier.emailFong, CY: cygfong@HKUSUA.hku.hken_HK
dc.identifier.emailCheung, RTF: rtcheung@hku.hken_HK
dc.identifier.emailHo, SL: slho@hku.hken_HK
dc.identifier.authorityCheung, RTF=rp00434en_HK
dc.identifier.hkuros143700en_HK
dc.identifier.volume9en_HK
dc.identifier.issueS2en_HK
dc.identifier.spage8en_HK

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