Oslo Delirium Research Group, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
J Alzheimers Dis. 2020;77(1):183-190. doi: 10.3233/JAD-200364.
Delirium is associated with dementia and thus biomarkers reflecting neurodegeneration are of interest. Fatty acid-binding protein 3 (FABP3) is a cytoplasmic neuronal protein that has been isolated from the brain. It is released following brain injury and concentrations in cerebrospinal fluid (CSF) are also higher in neurodegenerative disorders such as Alzheimer's disease (AD).
To examine the relationship between CSF FABP3 concentration and delirium in hip fracture patients compared to a group of cognitively normal controls.
CFS FABP3 concentration was measured in 128 hip fracture patients with (n = 71) and without (n = 57) delirium, and in cognitively unimpaired adults ≥64 years (n = 124) undergoing elective surgery.
CSF FABP3 (pg/ml) concentration (median (IQR)) was higher in hip-fracture patients compared to cognitively normal controls (5.7 (4.2-7.7) versus 4.5 (3.4-6.1), p < 0.001). There was a significant weak correlation between age and CSF FABP3 (ρ= 0.3, p < 0.001). After adjustment for age, the association between CSF FABP3 and hip-fracture was no longer statistically significant (β= 0.05, p = 0.5). There were no significant differences in CSF FABP3 concentration between hip fracture patients with (5.4 (4.1-8.2)) and without (5.8 (4.2-7.2)) delirium. CSF FABP3 concentration correlated positively with CSF AD biomarkers p-tau (ρ= 0.7, p < 0.01) and t-tau (ρ= 0.7, p < 0.01).
CSF FABP3 concentrations were higher in hip fracture patients compared with cognitively normal older adults, indicating ongoing age-related neurodegeneration in these patients. There were no differences of CSF FABP3 concentrations across delirium groups, suggesting that neuronal damage or degeneration reflected by FABP3 may not be directly linked to delirium pathophysiology.
谵妄与痴呆有关，因此反映神经退行性变的生物标志物很有意义。脂肪酸结合蛋白 3（FABP3）是一种细胞质神经元蛋白，已从大脑中分离出来。它在脑损伤后释放，在神经退行性疾病（如阿尔茨海默病（AD））中脑脊液（CSF）中的浓度也更高。
检查髋关节骨折患者与认知正常对照组相比，CSF FABP3 浓度与谵妄之间的关系。
测量了 128 例髋关节骨折患者（谵妄组 n=71，无谵妄组 n=57）和认知正常的成人（年龄≥64 岁，n=124）的 CSF FABP3 浓度。
与认知正常对照组相比，髋关节骨折患者的 CSF FABP3（pg/ml）浓度（中位数（IQR））更高（5.7（4.2-7.7）比 4.5（3.4-6.1），p<0.001）。年龄与 CSF FABP3 之间存在显著的弱相关性（ρ=0.3，p<0.001）。调整年龄后，CSF FABP3 与髋关节骨折之间的关联不再具有统计学意义（β=0.05，p=0.5）。髋关节骨折患者（5.4（4.1-8.2））和无谵妄患者（5.8（4.2-7.2））的 CSF FABP3 浓度无显著差异。CSF FABP3 浓度与 CSF AD 生物标志物 p-tau（ρ=0.7，p<0.01）和 t-tau（ρ=0.7，p<0.01）呈正相关。
与认知正常的老年成年人相比，髋关节骨折患者的 CSF FABP3 浓度更高，表明这些患者存在与年龄相关的神经退行性变。谵妄组的 CSF FABP3 浓度无差异，表明 FABP3 反映的神经元损伤或变性可能与谵妄病理生理学无直接关系。
