Wang Fei, Tang Xinhui, Wang Jiahan, Liu Siyv, Wu Xiaoyue, Dong Rui, Lin Xu, Wang Bin, Bi Yanlin
Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, China.
Department of Anesthesiology, Dalian Medical University, Dalian, China.
Front Aging Neurosci. 2022 Jul 14;14:909738. doi: 10.3389/fnagi.2022.909738. eCollection 2022.
The relationship between preoperative serum uric acid (SUA) and cerebrospinal fluid (CSF) Alzheimer-related biomarkers were investigated to determine whether high SUA is a potential risk factor for postoperative delirium (POD) and to evaluate its predictive efficacy.
The participants were selected from the Perioperative Neurocognitive Disorder Risk Factor and Prognosis (PNDRFAP) study and the Perioperative Neurocognitive Disorder and Biomarker Lifestyle (PNDABLE) study. The logistic regression equation was used to analyze the risk factors and protective factors of POD. The interaction term (SUA × Sex) was introduced into the linear model to explore the potential modification effects of sex on the identified correlations. We analyzed the mediating effects of Alzheimer-related biomarkers. Finally, we constructed the receiver operating characteristic (ROC) curve and the nomogram model to evaluate the efficacy of SUA and Alzheimer-related biomarkers in predicting POD.
Patients with POD had elevated SUA level (PNDRFAP: = 0.002, PNDABLE: < 0.001). Preoperative SUA level was positively correlated with CSF phosphorylated tau (P-tau) ( = 0.027) and β-amyloid42 (Aβ)/P-tau ( = 0.023). Interaction analysis did not find any modification effect of sex. The relationship between SUA and POD was partially mediated by CSF P-tau (15.3%). ROC curve showed that the model combining SUA and Alzheimer-related biomarkers had better performance in predicting POD [area under the curve (AUC) = 0.880; < 0.001], and the predictive model is accurate.
High SUA may enhance CSF P-tau level, thus increasing the risk of POD, and the model combining SUA and Alzheimer-related biomarkers can accurately predict the occurrence of POD.
研究术前血清尿酸（SUA）与脑脊液（CSF）中阿尔茨海默病相关生物标志物之间的关系，以确定高SUA是否为术后谵妄（POD）的潜在危险因素，并评估其预测效能。
参与者选自围手术期神经认知障碍危险因素与预后（PNDRFAP）研究和围手术期神经认知障碍与生物标志物生活方式（PNDABLE）研究。采用逻辑回归方程分析POD的危险因素和保护因素。将交互项（SUA×性别）引入线性模型，以探讨性别对已确定相关性的潜在修正作用。我们分析了阿尔茨海默病相关生物标志物的中介作用。最后，构建受试者工作特征（ROC）曲线和列线图模型，以评估SUA和阿尔茨海默病相关生物标志物在预测POD方面的效能。
POD患者的SUA水平升高（PNDRFAP： = 0.002，PNDABLE： < 0.001）。术前SUA水平与CSF磷酸化tau蛋白（P-tau）（ = 0.027）和β淀粉样蛋白42（Aβ）/P-tau（ = 0.023）呈正相关。交互分析未发现性别有任何修正作用。SUA与POD之间的关系部分由CSF P-tau介导（15.3%）。ROC曲线显示，联合SUA和阿尔茨海默病相关生物标志物的模型在预测POD方面表现更好[曲线下面积（AUC） = 0.880； < 0.001]，且预测模型准确。
高SUA可能会提高CSF P-tau水平，从而增加POD的风险，联合SUA和阿尔茨海默病相关生物标志物的模型可以准确预测POD的发生。
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