medigraphic.com
SPANISH

Revista Cubana de Neurología y Neurocirugía

ISSN 2225-4676 (Electronic)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2020, Number 2

<< Back Next >>

Rev Cubana Neurol Neurocir 2020; 10 (2)

Normal range of total proteins in cerebrospinal fluid according to age and sex

Betancourt LM, Peña SM, Menéndez SMC, Fernández AI, González QMA
Full text How to cite this article

Language: Spanish
References: 30
Page: 1-17
PDF size: 461.60 Kb.


Key words:

differences by sex, cerebrospinal fluid, total proteins, age groups, reference values, normal values.

ABSTRACT

Objective: To determine the ranges of total protein values in cerebrospinal fluid by age groups and their relationship with sex.
Methods: A descriptive analytical study was carried out. Total protein concentration was quantified (Lowry's procedure) in 930 cerebrospinal fluid samples with an electrophoretic pattern of normal cerebrospinal fluid, evaluated at the Institute of Neurology and Neurosurgery over a period of 11 years. Sex and age of the patients were recorded. The mean, median, minimum and maximum, standard deviation and 25-75 percentile of the concentration of total proteins in cerebrospinal fluid by age group were reported. Student's t-statistic was used for comparisons between adults and children and between sexes; ANOVA test was used to compare means of total proteins between age groups; Kruskal Wallis test determined differences between adult-age groups, and Mann-Whitney test analyzed the differences between sexes by age groups. The level of significance was p< 0.05.
Results: Reference values of total proteins in cerebrospinal fluid were determined by age groups; there were significant differences among them. The information previously reported on the association between higher values of total proteins in cerebrospinal fluid with advancing age was confirmed, with the exception of patients< 1 year. The total proteins of younger adults showed significant differences with respect to those of older. Higher values were evidenced in male adults; statistical significance was at the ages ranging 20 to 49 years.
Conclusions: Age and sex are essential in the analysis and interpretation of total protein values in cerebrospinal fluid. However, age and sex stratification is more relevant in patients older than 50 years.


REFERENCES

  1. González-Quevedo A, Peña-Sánchez M, García S. Editorial on “Cerebrospinal fluid total protein reference intervals derived from 20 years of patient data”. J Lab Precis Med. 2018 Abr;3(35). Doi: 10.21037/jlpm.2018.03.12

  2. Bourque PR, Breiner A, Moher D, Brooks J, Hegen H, Deisenhammer F, et. al. Adult CSF total protein: Higher upper reference limits should be considered worldwide. A web-based survey. J Neurol Sci. 2019 Ene 15 [citado: 08/02/2020];396:48-51. Disponible en: https://doi.org/10.1016/j.jns.2018.10.033

  3. Bourque PR, Brooks J, Warman‑Chardon J, Breiner A. Cerebrospinal fluid total protein in Guillain–Barré syndrome variants: correlations with clinical category, severity, and electrophysiology. J Neurol. 2019 Nov;267(8). Doi: 10.1007/s00415-019-09634-0

  4. Deisenhammer F, Bartos A, Egg R, Gilhus NE, Giovannoni G, Rauer S, et al. Guidelines on routine cerebrospinal fluid analysis. Report from an EFNS task force. Eur J Neurol. 2006 Oct;13(9):913-22. Doi: 10.1111/j.1468-1331.2006.01493.x

  5. Breiner A, Bourque PR, Allen JA. Updated Cerebrospinal Fluid Total Protein Reference Values Improve CIDP Diagnosis. Muscle Nerve. 2019 Abr;60(9):180-3. Doi: 10.1002/mus.26488

  6. McCudden CR, Brooks J, Figurado P, Bourque PR. Cerebrospinal fluid total protein reference intervals derived from 20 years of patient data. Clin Chem. 2017 Dic [citado: 08/02/2020];63(12):1856-65. Disponible en: https://academic.oup.com/clinchem/article/63/12/1856/5612767

  7. Bourque PR, Brooks J, Warman‑Chardon J, Hegen H, Deisenhammer F, McCudden ChR. Dataset for worldwide survey of cerebrospinal total protein upper reference values. Data Brief. 2019 Abr;23:103760. Doi: 10.1016/j.dib.2019.103760

  8. Daroff RB, Bradley WG, Jankovic J, Mazziotta JC, Pomeroy SL. Bradley's neurology in clinical practice. t. 2, 7 ed. London: Elsevier; 2016.

  9. Hühmer AF, Biringer RG, Amato H, Fonteh AN, Harrington MG. Protein analysis in human cerebrospinal fluid: Physiological aspects, current progress and future challenges. Dis Markers. 2006 Feb [citado: 12/02/2020];22(1-2):3-26. Disponible en: http://downloads.hindawi.com/journals/dm/2006/158797.pdf

  10. González-Quevedo A, Fernández-Carriera R, León-Ortiz MM, González-García S, Vicente-Valdés I. Electroforesis de proteínas del líquido cefalorraquídeo normal en niños y adultos. Rev Mex Neuroci. 2008 May-Jun [citado: 12/02/2020];9(3):242-7. Disponible en: http://previous.revmexneurociencia.com/wp-content/uploads/2014/06/Nm083-12-erratum.pdf

  11. Hegen H, Auer M, Zeileis A, Deisenhammer F. Upper reference limits for cerebrospinal fluid total protein and albumin quotient based on a large cohort of control patients: implications for increased clinical specificity. Clin Chem Lab Med. 2016 Feb;54(2):285-92. Doi: 10.1515/cclm-2015-0253

  12. Lowry OH, Rosebrough NJ, Farr AL, Randall RJ. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951;193(1):265-75.

  13. Grisold, W. Editorial for adult CSF total protein: Higher upper reference limits should be considered worldwide. A web-based survey. J Neurol Sci. J Neurol Sci. 2019 Feb;397:181-2. Doi: 10.1016/j.jns.2018.10.030

  14. Biou D, Benoist JF, Nguyen-Thi C, Huong X, Morel P, Marchand M. Cerebrospinal fluid protein concentrations in children: age-related values in patients without disorders of the central nervous system. Clin Chem. 2000;46(3):399-403. Doi: 10.1093/clinchem/46.3.399

  15. Wong M, Schlaggar BL, Buller RS, Storch GA, Landt M. Cerebrospinal fluid protein concentration in pediatric patients: defining clinically relevant reference values. Arch Pediatr Adolesc Med. 2000 Sep;154(8):827-31. Doi: 10.1001/archpedi.154.8.827

  16. Renuart AJ, Mistry RD, Avery RA, Licht DJ, Seiden JA, Huh JW, et al. Reference range for cerebrospinal fluid protein concentration in children and adolescents. Arch Pediatr Adolesc Med. 2011 Jul;165(7):671-3. Doi: 10.1001/archpediatrics.2011.89

  17. Kahlmann V, Roodbol J, van Leeuwen N, Ramakers CRB, van Pelt D, Neuteboom RF, et al. Validated age-specifc reference values for CSF total protein levels in children. Eur J Paediatr Neurol. 2017 Abr 08;21:654-60. Doi: 10.1016/j.ejpn.2017.03.006

  18. Breebaart K, Becker H, Jongebloed FA. Investigation of reference values of components of cerebrospinal fluid. J Clin Chem Clin Biochem. 1978 Jun [citado: 18/10/2019];16:561-5. Disponible en: https://edoc.hu-berlin.de/bitstream/handle/18452/10763/18.pdf?sequence=1

  19. Dufour-Rainfray D, Beaufils E, Vourc’h P, Vierron E, Mereghetti L, Gendrot C, et al. Total protein level in cerebrospinal fluid is stable in elderly adults. J Am Geriatr Soc. 2013 [citado: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jgs.12489

  20. Thomson J, Sucharew H, Cruz AT, Nigrovic LE, Freedman SB, Garro, AC, et al. Cerebrospinal Fluid Reference Values for Young Infants Undergoing Lumbar Puncture. Pediatrics. 2018 Feb;141(3):e20173405. Doi: 10.1542/peds.2017-3405

  21. Noureldein M, Mardare R, Pickard J, Shing HL, Eisenhut M. Cerebrospinal fluid protein and glucose levels in neonates with a systemic inflammatory response without meningitis. Fluids Barriers CNS. 2018 Mar 14;15(1). Doi: 10.1186/s12987-018-0095-4.

  22. Quintela T, Marcelino H, Deery MJ, Feret R, Howard J, Lilley KS, et. al. Sex-related differences in rat choroid plexus and cerebrospinal fluid: a cDNA microarray and proteomic analysis. J Neuroendocrinol. 2016 Ene;28(1). Doi: 10.1111/jne.12340

  23. Erdó F, Denes L, de Lange E. Age-associated physiological and pathological changes at the blood–brain barrier: a review. J Cereb Blood Flow Metab. 2017 Ene;37(1):4-24. Doi: 10.1177/0271678X16679420

  24. Reiber H. Proteins in cerebrospinal fluid and blood: barriers, CSF flow rate and source-related dynamics. Restor Neurol Neurosci. 2003 Feb [citado: 20/01/2020];21(3-4):79-96. Disponible en: https://pdfs.semanticscholar.org/aa0b/8213acae04cd045c992da03c73217b71fb05.pdf

  25. Garton MJ, Keir G, Vijaya Lakshmi M, Thompson EJ. Age-related changes in cerebrospinal fluid protein concentrations. J Neurol Sci. 1991 Jul [citado: 18/01/2020];104(1):74-80. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/0022510X9190218V

  26. Breiner A, Moher D, Brooks J, Cheng W, Hegen H, Deisenhammer F, et. al. Adult CSF total protein upper reference limits should be age-partitioned and significantly higher than 0.45 g/L: a systematic review. J Neurol. 2019 Ene;266(12):616-24. Doi: 10.1007/s00415-018-09174-z

  27. Curtis KS. Estrogen and the central control of body fluid balance. Physiol Behav. 2009 Abr;97(2):180-92. Doi: 10.1016/j.physbeh.2009.02.027

  28. Salas Rubio JH. Neurocirugía. Diez temas fundamentales. La Habana: Editorial Ciencias Médicas; 2020.

  29. Chen CP, Chen RL, Preston JE. The influence of cerebrospinal fluid turnover on age-related changes in cerebrospinal fluid protein concentrations. Neurosci Lett. 2010 Jun;476(3):138-41. Doi: 10.1016/j.neulet.2010.04.015

  30. Bhattacharya C. A simple method of resolution of a distribution into Gaussian components. Biometrics. 1967 Mar [citado: 18/02/2020];23(1):115-35. Disponible en: https://www.jstor.org/stable/2528285




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Cubana Neurol Neurocir. 2020;10