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Lactate And Pyruvate Content Of The Human Cisternal Cerebrospinal Fluid

B. Vámosi, P. Diószeghy, L. Molnár
Published 2004 · Chemistry, Medicine

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SummaryCisternal CSF specimens were obtained from 144 fasted individuals free from organic brain disease (42 males and 102 females; mean age 41±10.3 years, range 16–69 years). In 30 cases a simultaneous lumbar puncture was also performed. The concentration of CSF glucose (Gl) was measured by the o-toluidine method, and that of lactate (La) and pyruvate (Py) by enzymatic tests. No significant difference was found between the mean Gl and Py values of the lumbar and cisternal CSF but the lumbar La was somewhat higher than the cisternal one (P<0.10). In the cisternal CSF the frequency distribution of Gl, La and Py samples was a Gaussian one (P<0.05). The normal ranges, as mean±2 SD, were for La 0.680—2.100 mM/l, and for Py 0.067–0.141 mM/l, respectively. It is proposed that values at the upper and lower limits of the range (between ¯x±2 SD and ¯x± 1 SD) are considered to be potentially pathological. No significant difference was found between the mean Gl, La and Py values in males and females. Consistent age-related changes could not be detected either in the Gl or Py levels, however, a tendency for La increase was observed in the oldest age-group (over 54 years). A negative correlation was found between the Gl and La concentrations of the cisternal CSF (r=0.375; P<0.001).ZusammenfassungEs wurden 144 Personen (42 Männer und 102 Frauen, Durchschnittsalter 41,2±10,3 Jahre — 16–69 Jahre) frei von hirnorganischen Erkrankungen untersucht. Zisternale Liquorproben wurden auf nüchternen Magen entnommen und in 30 Fällen wurde gleichzeitig auch eine Lumbalpunktion durchgeführt. Die Konzentration der Glukose (Gl) wurde mit der Orthotoluidinmethode, die des Laktats (La) und Pyruvats (Py) enzymatisch gemessen. Es konnte keine wesentliche Differenz zwischen den Mittelwerten des lumbalen und zisternalen GL und Py gefunden werden, der lumbale La-Spiegel war aber nahe signifikant höher als der zisternale (P<0,10). Die statistischen Verteilungen der zisternalen La- und Py-Werte entsprachen der Gaußschen Distribution (P<0,05). Als Normbereich ergaben sich für den zisternalen La-Gehalt 0,680–2,100 mM/l, und für den Py-Gehalt 0,067–0,141 mM/l. Es wird vorgeschlagen, die Bereiche zwischen ¯x±2 SD und ¯x±1 SD, im Sinne der sogenannten „grauen Zonen“ als untere und obere Grenzzonen zu bezeichnen. Werte, die in diese Grenzzonen fallen, sind als auffällig oder als potentiell pathologisch zu verzeichnen. Keine geschlechtsabhängigen Unterschiede zwischen den Gl-, La- und Py-Werten der Männer und Frauen sowie keine altersabhängigen Änderungen der Gl- und Py-Konzentrationen konnten nachgewiesen werden. Es wurde hingegen eine Erhöhungstendenz des La-Spiegels bei Personen über 54 Jahren gefunden. Zwischen den Gl- und der La-Konzentrationen konnte eine negative Korrelation nachgewiesen werden (r=−0,375, P<0,001).
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