The relationship between body mass index and postoperative delirium

Brain and Behavior

He Tao¹  Yanlin Bi²  Xu Lin²  Bin Wang²  Xiyuan Deng²  Peijuan Qin²  Fanghao Liu²  Yanan Lin³ 

[1] Department of Anesthesiology Dalian Medical University Dalian China;Department of Anesthesiology Qingdao Municipal Hospital Affiliated to Qingdao University Qingdao China;Department of Anesthesiology Weifang Medical University Weifang China;

关键词: body mass index;    cerebrospinal fluid;    mediation analysis;    postoperative delirium;    tau proteins;   

DOI  :  10.1002/brb3.2534

来源: DOAJ

【 摘 要 】

Abstract Purpose We aimed to investigate the relevance of body mass index (BMI) to postoperative delirium (POD), and to test whether the influences of BMI on POD were mediated by cerebrospinal fluid (CSF) biomarkers. Patients and methods Our study recruited 682 and 761 cognitively intact individuals from the perioperative neurocognitive disorder risk factor and prognosis (PNDRFAP) study and the perioperative neurocognitive disorder and biomarker lifestyle (PNDABLE) study, respectively. The incidence of POD was evaluated by using Confusion Assessment Method (CAM), and POD severity was measured by using the Memorial Delirium Assessment Scale (MDAS). Logistic regression was used to analyze the relationship between BMI and POD. The levels of Aβ40, Aβ42, T‐tau, and P‐tau in preoperative CSF were measured by enzyme‐linked immune‐sorbent assay (ELISA) in the PNDABLE study. Mediation analysis with 5000 bootstrapped iterations was used to explore the mediation effects. Results In the PNDRFAP study, the incidence of POD was 16.3%, with logistic regression analysis showing that BMI (odds ratio [OR] = 0.900, 95% confidence interval [CI] 0.823–0.985, p = .022) is a protective factor of POD. In the PNDABLE study, the incidence of POD was 18.7%, and regression analysis confirmed that BMI (OR = 0.832, 95% CI 0.761–0.910, p < .001) is a protective factor of POD, while T‐tau (OR = 1.005, 95% CI 1.003–1.006, p < .001) and P‐tau (OR = 1.037, 95% CI 1.024–1.050, p < .001) were risk factors of POD. Mediation analyses revealed that the association between BMI and POD was partially mediated by T‐tau (proportion: 36%) and P‐tau (proportion: 24%). Conclusion Higher BMI mediated protective effects on POD through CSF biomarkers (T‐tau and P‐tau).

【 授权许可】

Unknown