Department of Anesthesiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, China.
Yixing Clinical College, Medical College of Yangzhou University, Yixing, China.
Brain Behav. 2020 Oct;10(10):e01800. doi: 10.1002/brb3.1800. Epub 2020 Aug 17.
Brain-derived neurotrophic factor (BDNF) plays a critical role in the pathogenesis of postoperative cognitive dysfunction (POCD). In present study, we aimed to assess the possible association between POCD and BDNF rs6265 polymorphisms.
124 patients aged 60 years or older scheduled for elective surgery under general anesthesia and 25 age- and gender-matched healthy volunteers were recruited. POCD was identified using a neuropsychological test battery administered preoperatively, 7 days, and 3 months after surgery. Genotyping of rs6265 was performed using polymerase chain reaction amplification and restriction fragment length polymorphism analysis.
99 patients and 25 healthy controls were finally enrolled in the analysis. 29(29.3%) and 18(18.2%) of 99 patients had POCD at 7 days and 3 months after surgery, respectively. The patients carrying a G allele at the rs6265 locus showed a lower risk for POCD than an A allele carriers on postoperative 7 days, but not 3 months after surgery (OR = 0.67; 95% CI: 0.47-0.96; p = .017; OR = 0.69; 95% CI: 0.42-1.13; p = .14, respectively). The risk of POCD at 7 days following surgery was significantly lower in additive model (OR = 0.41; 95% CI: 0.2-0.84; p = .015) and dominant model (OR = 0.35; 95% CI: 0.13-0.96; p = .042).
We tentatively demonstrate that BDNF rs6265 polymorphisms might be associated with occurrence of POCD at 7 days after surgery and the A > G mutant at the rs6265 locus be likely a protective factor for early POCD in Chinese Han population.
脑源性神经营养因子（BDNF）在术后认知功能障碍（POCD）的发病机制中起关键作用。在本研究中，我们旨在评估 BDNF rs6265 多态性与 POCD 之间的可能关联。
招募了 124 名年龄在 60 岁或以上、接受全身麻醉下择期手术的患者和 25 名年龄和性别匹配的健康志愿者。使用神经心理学测试工具包在术前、术后 7 天和 3 个月评估 POCD。使用聚合酶链反应扩增和限制性片段长度多态性分析对 rs6265 进行基因分型。
99 名患者和 25 名健康对照者最终纳入分析。99 名患者中有 29 名（29.3%）和 18 名（18.2%）在术后 7 天和 3 个月后出现 POCD。与 A 等位基因携带者相比，携带 rs6265 位点 G 等位基因的患者术后 7 天发生 POCD的风险较低，但术后 3 个月时无差异（OR=0.67；95%CI：0.47-0.96；p=0.017；OR=0.69；95%CI：0.42-1.13；p=0.14）。在加性模型（OR=0.41；95%CI：0.2-0.84；p=0.015）和显性模型（OR=0.35；95%CI：0.13-0.96；p=0.042）中，术后 7 天 POCD 的风险显著降低。
我们初步证明 BDNF rs6265 多态性可能与术后 7 天 POCD 的发生有关，rs6265 位点的 A>G 突变可能是中国汉族人群早期 POCD 的保护因素。
