Jung Mijin, Pan Xiaobei, Cunningham Emma L, Passmore Anthony P, McGuinness Bernadette, McAuley Daniel F, Beverland David, O'Brien Seamus, Mawhinney Tim, Schott Jonathan M, Zetterberg Henrik, Green Brian D
Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 8 Malone Road, Belfast BT9 5BN, Northern Ireland, UK.
Centre for Public Health, Institute of Clinical Sciences, Queen's University Belfast, Block B, Royal Victoria Hospital Site, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK.
Metabolites. 2022 Jul 1;12(7):616. doi: 10.3390/metabo12070616.
The mechanisms underlying the occurrence of postoperative delirium development are unclear and measurement of plasma metabolites may improve understanding of its causes. Participants ( = 54) matched for age and gender were sampled from an observational cohort study investigating postoperative delirium. Participants were ≥65 years without a diagnosis of dementia and presented for primary elective hip or knee arthroplasty. Plasma samples collected pre- and postoperatively were grouped as either control ( = 26, aged: 75.8 ± 5.2) or delirium ( = 28, aged: 76.2 ± 5.7). Widespread changes in plasma metabolite levels occurred following surgery. The only metabolites significantly differing between corresponding control and delirium samples were ornithine and spermine. In delirium cases, ornithine was 17.6% higher preoperatively, and spermine was 12.0% higher postoperatively. Changes were not associated with various perioperative factors. In binary logistic regression modeling, these two metabolites did not confer a significantly increased risk of delirium. These findings support the hypothesis that disturbed polyamine metabolism is an underlying factor in delirium that warrants further investigation.
术后谵妄发生的潜在机制尚不清楚，血浆代谢物的检测可能有助于更好地理解其病因。从一项调查术后谵妄的观察性队列研究中选取了年龄和性别匹配的参与者（n = 54）。参与者年龄≥65岁，无痴呆诊断，因初次择期髋关节或膝关节置换术就诊。术前和术后采集的血浆样本分为对照组（n = 26，年龄：75.8±5.2）或谵妄组（n = 28，年龄：76.2±5.7）。术后血浆代谢物水平发生了广泛变化。相应的对照组和谵妄组样本之间唯一显著不同的代谢物是鸟氨酸和精胺。在谵妄病例中，术前鸟氨酸高17.6%，术后精胺高12.0%。这些变化与各种围手术期因素无关。在二元逻辑回归模型中，这两种代谢物并未显著增加谵妄风险。这些发现支持了以下假设，即多胺代谢紊乱是谵妄的一个潜在因素，值得进一步研究。
