Psychiatry Investig.  2016 May;13(3):327-332. 10.4306/pi.2016.13.3.327.

Lack of Association between Pre-Operative Insulin-Like Growth Factor-1 and the Risk of Post-Operative Delirium in Elderly Chinese Patients

• Chu CS
• Liang CK
• Chou MY
• Lin YT
• Hsu CJ
• Chu CL
• Chou PH

• KMID: 2316651
• DOI: http://doi.org/10.4306/pi.2016.13.3.327

Abstract

OBJECTIVE
Postoperative delirium (POD) is a highly prevalent complex neuropsychiatric syndrome in elderly patients. However, its pathophysiology is currently unknown. Early detection and prevention of POD is important; therefore, the aim of this study was to investigate the link between preoperative insulin growth factor 1 (IGF-1) levels in the serum and POD in the Chinese elderly patients.
METHODS
One hundred and three patients who were undergoing an orthopedic operation took part in the study. Preoperative serum IGF-1 levels were measured. POD was determined daily using the Confusion Assessment Method (CAM) and DSM-IV TR. Baseline serum IGF-1 levels were compared between patients who did and did not develop POD. Correlation coefficients were calculated to evaluate relationship between baseline characteristics and serum IGF-1 levels. The relationship between baseline biomarkers and delirium status was investigated using logistic regression analysis, adjusting for potential confounding variables.
RESULTS
Twenty-three patients developed POD. The POD group had lower MMSE scores and higher CCI scores and proportions of acute admission. Preoperative serum IGF-1 levels were correlated with MMSE scores and age (MMSE: r=0.230, p<0.05; age: r=-0.419, p<0.001). Baseline serum IGF-1 levels did not differ between patients who did and did not develop POD, even after adjusting for potential confounding factors, MMSE score, and age.
CONCLUSION
No association was found between preoperative IGF-1 levels and POD, suggesting that they are not direct biomarkers of the incidence of POD among the Chinese elderly population. Further research with larger sample sizes is warranted to clarify the relationship.

Keyword

IGF-1; Postoperative delirium; Elderly

MeSH Terms

Aged*
Asian Continental Ancestry Group*
Biomarkers
Confounding Factors (Epidemiology)
Delirium*
Diagnostic and Statistical Manual of Mental Disorders
Humans
Incidence
Insulin
Insulin-Like Growth Factor I
Logistic Models
Orthopedics
Sample Size
Insulin
Insulin-Like Growth Factor I