title: Fasting and postprandial cerebrospinal fluid glucose concentrations in healthy women and in an obese binge eater.
abstract: OBJECTIVE
  We hypothesized that abnormal entry of glucose into the central nervous system (CNS) might exist in some chronic binge eaters of carbohydrates, as either a cause or consequence of binge eating. The purpose of this study was thus to determine fasting and postprandial glucose concentrations in the cerebrospinal fluid (CSF) of healthy women, and to obtain similar data in an obese, irritable woman with chronic binge eating of postpartum onset.
  
  
  METHODS
  CSF was sampled continuously at 0.1 ml/min from 1100 hr to 1700 hr from the binge eating patient, who consumed 5,000 to 10,000 calories per day (preferentially binging on refined carbohydrates), and 4 healthy women via an indwelling, flexible spinal canal catheter. CSF aliquots were obtained at 10-min intervals for measurement of glucose concentrations. Simultaneously, blood was withdrawn at 30-min intervals to obtain serum for glucose assay. A glucose-rich mixed liquid meal was consumed by participants at 1300 hr.
  
  
  RESULTS
  In striking contrast to the normal women, our bulimic patient showed no postprandial rise whatever in CSF glucose concentrations. Fasting CSF glucose concentrations were slightly lower whereas fasting serum glucose levels were normal in the bulimic patient, compared with the normal women. After eating, serum glucose levels increased in all participants, but less so in our patient.
  
  
  CONCLUSIONS
  This is the first description of a lack of postprandial elevation in CSF glucose concentration in a patient with a binge eating disorder. Defective transport of glucose across the blood-brain barrier might account for the observed abnormality. While considering other possibilities, we conjecture that our patient's binge eating was an attempt to compensate for impaired postprandial entry of glucose into her CNS.
authors.affiliation: University of Cincinnati Medical Center, Ohio, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Geracioti
authors.forename: P T
authors.initials: PT
authors.lastname: Loosen
authors.forename: M H
authors.initials: MH
authors.lastname: Ebert
authors.forename: D
authors.initials: D
authors.lastname: Schmidt
authors.forename: N N
authors.initials: NN
authors.lastname: Ekhator
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001812:Blood-Brain Barrier / Q000502:physiology; D001921:Brain / Q000378:metabolism; D002032:Bulimia / Q000134:cerebrospinal fluid* / Q000178:diet therapy / Q000523:psychology; D002149:Energy Intake / Q000502:physiology; D005215:Fasting / Q000134:cerebrospinal fluid* / Q000523:psychology; D005260:Female; D006801:Humans; D006963:Hyperphagia / Q000134:cerebrospinal fluid* / Q000178:diet therapy / Q000523:psychology; D008875:Middle Aged; D009765:Obesity / Q000134:cerebrospinal fluid* / Q000178:diet therapy / Q000523:psychology; D012016:Reference Values
chemical_list: D001786:Blood Glucose