蝶呤：老年患者谵妄的潜在生物标志物。

Neopterin: a potential biomarker for delirium in elderly patients.

作者信息

Egberts Angelique, Wijnbeld Eline H A, Fekkes Durk, van der Ploeg Milly A, Ziere Gijsbertus, Hooijkaas Herbert, van der Cammen Tischa J M, Mattace-Raso Francesco U S

机构信息

Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

出版信息

Dement Geriatr Cogn Disord. 2015;39(1-2):116-24. doi: 10.1159/000366410. Epub 2014 Nov 19.

DOI:10.1159/000366410

PMID:25413160

Abstract

BACKGROUND/AIMS: The diagnosis of delirium is not supported by specific biomarkers. In a previous study, high neopterin levels were found in patients with a postoperative delirium. In the present study, we investigated levels of neopterin, interleukin-6 (IL-6) and insulin-like growth factor-1 (IGF-1) in acutely ill admitted elderly patients with and without a delirium.

METHODS

Plasma/serum levels of neopterin, IL-6 and IGF-1 were determined in patients aged ≥65 years admitted to the wards of Internal Medicine and Geriatrics. Differences in biomarker levels between patients with and without a delirium were investigated by the analysis of variance in models adjusted for age, gender, comorbidities and eGFR (when appropriate).

RESULTS

Eighty-six patients were included; 23 of them with a delirium. In adjusted models, higher mean levels of neopterin (70.5 vs. 45.9 nmol/l, p = 0.009) and IL-6 (43.1 vs. 18.5 pg/ml, p = 0.034) and lower mean levels of IGF-1 (6.3 vs. 9.3 nmol/l, p = 0.007) were found in patients with a delirium compared to those without.

CONCLUSIONS

The findings of this study suggest that neopterin might be a potential biomarker for delirium which, through oxidative stress and activation of the immune system, may play a role in the pathophysiology of delirium.

摘要

背景/目的：谵妄的诊断缺乏特异性生物标志物支持。在之前的一项研究中，发现术后谵妄患者的新蝶呤水平较高。在本研究中，我们调查了入住内科和老年病科的急性病老年患者中，有谵妄和无谵妄患者的新蝶呤、白细胞介素-6（IL-6）和胰岛素样生长因子-1（IGF-1）水平。

方法

测定年龄≥65岁入住内科和老年病科病房患者的血浆/血清新蝶呤、IL-6和IGF-1水平。通过在调整了年龄、性别、合并症和估算肾小球滤过率（eGFR，如适用）的模型中进行方差分析，研究有谵妄和无谵妄患者生物标志物水平的差异。

结果

纳入86例患者；其中23例有谵妄。在调整模型中，与无谵妄患者相比，有谵妄患者的新蝶呤平均水平更高（70.5对45.9 nmol/l，p = 0.009）、IL-6平均水平更高（43.1对18.5 pg/ml，p = 0.034），而IGF-1平均水平更低（6.3对9.3 nmol/l，p = 0.007）。