系统性氧化应激与老年髋部骨折患者谵妄相关

IF 3.9

Experimental gerontology Pub Date : 2025-06-04 DOI:10.1016/j.exger.2025.112801

Monika Trzpis , Maria Zernova , Karin M. Vermeulen , Marian L.C. Bulthuis , Marjan Reinders-Luinge , Harry van Goor , Barbara C. van Munster , Arno R. Bourgonje

{"title":"系统性氧化应激与老年髋部骨折患者谵妄相关","authors":"Monika Trzpis , Maria Zernova , Karin M. Vermeulen , Marian L.C. Bulthuis , Marjan Reinders-Luinge , Harry van Goor , Barbara C. van Munster , Arno R. Bourgonje","doi":"10.1016/j.exger.2025.112801","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Oxidative stress ensues in patients undergoing surgery for hip fracture and has been implicated in the pathophysiology of delirium. Circulating free thiols (R-SH, sulfhydryl groups) serve as biomarker of systemic oxidative stress since they are rapidly oxidized by reactive species, acting as potent antioxidants. We aimed to investigate the relationship between delirium and systemic oxidative stress in older patients hospitalized with hip fracture.</div></div><div><h3>Methods</h3><div>Patients aged 65 years or more, acutely admitted due to hip fracture, were included between 2005 and 2008. Delirium was diagnosed according to the DSM-IV criteria for delirium. Free thiols were determined in plasma samples that had been collected longitudinally during hospitalization for previous clinical trial, using colorimetric detection. Albumin-adjusted plasma free thiol concentrations were both cross-sectionally and longitudinally evaluated in relation to delirium.</div></div><div><h3>Results</h3><div>In total 813 plasma samples from 336 patients were analysed. Delirium was experienced by 110 (33 %) patients. Mean albumin-adjusted free thiols of patients who experienced delirium (7.3 ± SD 1.4 μM/g) was lower than that of non-delirious patients (7.5 ± SD 1.3 μM/g) (<em>P</em> = 0.050). Multivariable logistic regression analysis, adjusted for age, preexisting cognitive impairment, institutionalization, time to surgery, and complications, indicated that delirium was significantly inversely associated with albumin-adjusted free thiol concentrations (OR = 0.8, 95%CI 0.75–0.96). The significant association between delirium and albumin-adjusted free thiols tested in all the samples was also shown by linear mixed model analysis after adjusting for confounders (β = −0.292; 95%CI 0.04–0.55).</div></div><div><h3>Conclusions</h3><div>Reduced concentrations of free thiols, reflecting systemic oxidative stress, are associated with delirium onset among patients with hip fracture.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"207 ","pages":"Article 112801"},"PeriodicalIF":3.9000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Systemic oxidative stress associates with delirium in a geriatric population with hip fracture\",\"authors\":\"Monika Trzpis , Maria Zernova , Karin M. Vermeulen , Marian L.C. Bulthuis , Marjan Reinders-Luinge , Harry van Goor , Barbara C. van Munster , Arno R. Bourgonje\",\"doi\":\"10.1016/j.exger.2025.112801\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Oxidative stress ensues in patients undergoing surgery for hip fracture and has been implicated in the pathophysiology of delirium. Circulating free thiols (R-SH, sulfhydryl groups) serve as biomarker of systemic oxidative stress since they are rapidly oxidized by reactive species, acting as potent antioxidants. We aimed to investigate the relationship between delirium and systemic oxidative stress in older patients hospitalized with hip fracture.</div></div><div><h3>Methods</h3><div>Patients aged 65 years or more, acutely admitted due to hip fracture, were included between 2005 and 2008. Delirium was diagnosed according to the DSM-IV criteria for delirium. Free thiols were determined in plasma samples that had been collected longitudinally during hospitalization for previous clinical trial, using colorimetric detection. Albumin-adjusted plasma free thiol concentrations were both cross-sectionally and longitudinally evaluated in relation to delirium.</div></div><div><h3>Results</h3><div>In total 813 plasma samples from 336 patients were analysed. Delirium was experienced by 110 (33 %) patients. Mean albumin-adjusted free thiols of patients who experienced delirium (7.3 ± SD 1.4 μM/g) was lower than that of non-delirious patients (7.5 ± SD 1.3 μM/g) (<em>P</em> = 0.050). Multivariable logistic regression analysis, adjusted for age, preexisting cognitive impairment, institutionalization, time to surgery, and complications, indicated that delirium was significantly inversely associated with albumin-adjusted free thiol concentrations (OR = 0.8, 95%CI 0.75–0.96). The significant association between delirium and albumin-adjusted free thiols tested in all the samples was also shown by linear mixed model analysis after adjusting for confounders (β = −0.292; 95%CI 0.04–0.55).</div></div><div><h3>Conclusions</h3><div>Reduced concentrations of free thiols, reflecting systemic oxidative stress, are associated with delirium onset among patients with hip fracture.</div></div>\",\"PeriodicalId\":94003,\"journal\":{\"name\":\"Experimental gerontology\",\"volume\":\"207 \",\"pages\":\"Article 112801\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Experimental gerontology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0531556525001305\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Experimental gerontology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0531556525001305","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

摘要

背景：氧化应激在髋部骨折手术患者中出现，并与谵妄的病理生理有关。循环游离硫醇（R-SH，巯基）作为系统氧化应激的生物标志物，因为它们被活性物质迅速氧化，作为有效的抗氧化剂。我们旨在探讨老年髋部骨折住院患者谵妄与全身氧化应激的关系。方法纳入2005 - 2008年间因髋部骨折急性入院的65岁及以上患者。谵妄诊断依据DSM-IV谵妄标准。使用比色法检测先前临床试验住院期间纵向收集的血浆样品中的游离硫醇。白蛋白调节的血浆游离硫醇浓度在与谵妄的关系中进行了横断面和纵向评估。结果共分析336例患者813份血浆样本。110例（33%）患者出现谵妄。谵妄患者平均白蛋白调节游离硫醇（7.3±SD 1.4 μM/g）低于非谵妄患者（7.5±SD 1.3 μM/g）（P = 0.050）。多变量logistic回归分析，校正了年龄、先前存在的认知障碍、机构、手术时间和并发症，表明谵妄与白蛋白调整的游离硫醇浓度显著负相关（OR = 0.8, 95%CI 0.75-0.96）。在调整混杂因素后，线性混合模型分析也显示谵妄与所有样本中白蛋白调节的游离硫醇之间存在显著关联(β = - 0.292；95%可信区间0.04 - -0.55)。结论：反映全身氧化应激的游离硫醇浓度降低与髋部骨折患者谵妄发作有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Systemic oxidative stress associates with delirium in a geriatric population with hip fracture

Background

Oxidative stress ensues in patients undergoing surgery for hip fracture and has been implicated in the pathophysiology of delirium. Circulating free thiols (R-SH, sulfhydryl groups) serve as biomarker of systemic oxidative stress since they are rapidly oxidized by reactive species, acting as potent antioxidants. We aimed to investigate the relationship between delirium and systemic oxidative stress in older patients hospitalized with hip fracture.

Methods

Patients aged 65 years or more, acutely admitted due to hip fracture, were included between 2005 and 2008. Delirium was diagnosed according to the DSM-IV criteria for delirium. Free thiols were determined in plasma samples that had been collected longitudinally during hospitalization for previous clinical trial, using colorimetric detection. Albumin-adjusted plasma free thiol concentrations were both cross-sectionally and longitudinally evaluated in relation to delirium.

Results

In total 813 plasma samples from 336 patients were analysed. Delirium was experienced by 110 (33 %) patients. Mean albumin-adjusted free thiols of patients who experienced delirium (7.3 ± SD 1.4 μM/g) was lower than that of non-delirious patients (7.5 ± SD 1.3 μM/g) (P = 0.050). Multivariable logistic regression analysis, adjusted for age, preexisting cognitive impairment, institutionalization, time to surgery, and complications, indicated that delirium was significantly inversely associated with albumin-adjusted free thiol concentrations (OR = 0.8, 95%CI 0.75–0.96). The significant association between delirium and albumin-adjusted free thiols tested in all the samples was also shown by linear mixed model analysis after adjusting for confounders (β = −0.292; 95%CI 0.04–0.55).