title: Coefficient of energy balance: effective tool for early differential diagnosis of CNS diseases.
abstract: Urgent examination of cerebrospinal fluid (CSF) provides immediate important information about the character of central nervous system (CNS) impairment. Although this examination includes energy parameters such as glucose and lactate concentrations, it does not commonly use Coefficient of Energy Balance (CEB). In this study, we focused on CEB because it enables more exact assessment of actual energy state in the CSF compartment than glucose and lactate alone. CEB informs about the actual functioning condition of present cells, and it does not require any other analysis or costs. Using Kruskal-Wallis ANOVA, we examined a large CSF sample (n = 8183) and we compared CEB values among groups with different cytological syndromes. We found a statistically significant difference of CEB between the group with granulocyte pleocytosis and the control group. These results indicate a high degree of anaerobic metabolism caused by the oxidative burst of neutrophils. Similarly, we found a statistically significant difference of CEB between the control group and groups with tumorous oligocytosis plus pleocytosis and monocyte pleocytosis. This difference can be attributed to the oxidative burst of macrophages. Our findings suggest that CEB combined with CSF cytology has a great importance for diagnosis, differential diagnosis, and early therapy of CNS diseases.
authors.affiliation: Department of Clinical Biochemistry, Thomayer's Hospital, Vídeňská 800, 140 59 Prague, Czech Republic. klara.borecka11@gmail.com
authors.forename: Klára
authors.initials: K
authors.lastname: Bořecká
authors.forename: Pavel
authors.initials: P
authors.lastname: Adam
authors.forename: Ondřej
authors.initials: O
authors.lastname: Sobek
authors.forename: Lenka
authors.initials: L
authors.lastname: Hajduková
authors.forename: Věra
authors.initials: V
authors.lastname: Lánská
authors.forename: Petr
authors.initials: P
authors.lastname: Nekola
mesh_terms: D002493:Central Nervous System Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000378:metabolism*; D016543:Central Nervous System Neoplasms / Q000134:cerebrospinal fluid / Q000378:metabolism; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D004734:Energy Metabolism; D006801:Humans; D010586:Phagocytes / Q000378:metabolism / Q000473:pathology; D012016:Reference Values; D016897:Respiratory Burst