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Can urinary excretion rate of 8-isoprostrane and malonaldehyde predict postoperative cognitive dysfunction in aging?

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Abstract

Oxidative stress has been associated with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). However, little is known about oxidative stress in postoperative cognitive dysfunction (POCD) in aging. The aim of this study was to investigate urinary excretion rate of 8-isoprostane:creatinine (U8-isoPG:Cr) and malonaldehyde:creatinine (UMDA:Cr) to predict short-term POCD in elderly patients undergoing general and orthopedic surgery. 72 patients aged above 65 years were enrolled in this prospective observational study. Each patient underwent cognitive testing to determine POCD performed by an investigator before surgery and 1 week after surgery. Morning urine was collected at baseline, 1, 2, and 7 days postoperatively. U8-isoPG was performed using enzymelinked immunosorbent assay (ELISA), and UMDA levels were measured by chemiluminescence detection. Creatinine levels were also analyzed if differences in the oxidative biomarkers were observed in the urine creatinine concentration. (1). Of 72 patients who completed cognitive testing, postoperative cognitive dysfunction was detected in 29.2 % (n = 21) of patients in 7 days. (2) U8-isoPG:Cr levels in 7 days postoperatively were significantly higher in POCD patients compared with the non-POCD group (p = 0.01). When measuring change from baseline, U8-isoPG:Cr levels were higher than that of control groups (p = 0.01). (3) UMDA:Cr levels were significantly elevated in 1 and 2 days postoperatively in both groups (p < 0.05). U8-isoPG:Cr level seems to be a valuable marker to detect lipid peroxidation early in POCD patients. However, it will also be important to take into account or reduce potential confounders to improve the identification of changes in the status of oxidative stress as a marker for POCD.

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Acknowledgments

The study was funded by the Natural Science Foundation of China (NSFC 30872425). Special thanks to Dr. Janet Martin for her detailed editing and revision, who is the director of the Evidence Based Perioperative Clinical Outcomes Research (EPiCOR), the Department of Anesthesia & Perioperative Medicine of London Health Sciences Centre, University of Western Ontario, Canada.

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Authors and Affiliations

  1. Department of Anesthesiology, China Meitan General Hospital, Beijing, 100028, China

    Qinghao Cheng & Lei Li

  2. Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China

    Jiawan Wang, Anshi Wu & Yun Yue

  3. Department of Anesthesiology, Beijing United Family Hospital, Beijing, 100016, China

    Rujin Zhang

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  1. Qinghao Cheng
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  2. Jiawan Wang
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  3. Anshi Wu
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  4. Rujin Zhang
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Correspondence to Yun Yue.

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Cheng, Q., Wang, J., Wu, A. et al. Can urinary excretion rate of 8-isoprostrane and malonaldehyde predict postoperative cognitive dysfunction in aging?. Neurol Sci 34, 1665–1669 (2013). https://doi.org/10.1007/s10072-013-1314-z

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  • DOI: https://doi.org/10.1007/s10072-013-1314-z

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