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. 2023 Aug 22;23(1):284.
doi: 10.1186/s12871-023-02183-0.

The relationship between longer leukocyte telomeres and dNCR in non-cardiac surgery patients: a retrospective analysis

Chen Liu  1   2 , Ke Ding  1   3 , Mannan Abdul  1   4 , Qing-Chun Sun  1   5 , Zhen-Feng Zhang  1   5 , Meng-Meng Dong  1   6 , Liu Han  1 , Ming-Sheng Dai  1 , Hui-Lian Guan  1 , Yuan Han  1   4 , He Liu #  7   8 , Xue-Fen Chen #  9 , Jun-Li Cao  10   11
Affiliations

The relationship between longer leukocyte telomeres and dNCR in non-cardiac surgery patients: a retrospective analysis

Chen Liu et al. BMC Anesthesiol. .

Abstract

Background: Cognitive decline following surgery is a common concern among elderly individuals. Leukocyte telomere length (LTL) can be assessed as a biological clock connected to an individual lifespan. However, the mechanisms causing this inference are still not fully understood. As a result of this, LTL has the potential to be useful as an aging-related biomarker for assessing delayed neurocognitive recovery (dNCR) and related diseases.

Methods: For this study, 196 individuals over 60 who were scheduled due to major non-cardiac surgical operations attended neuropsychological testing before surgery, followed by additional testing one week later. The finding of dNCR was based on a measured Z-score ≤ -1.96 on two or more separate tests. The frequency of dNCR was presented as the primary outcome of the study. Secondly, we evaluated the association between dNCR and preoperative LTL.

Results: Overall, 20.4% [40/196; 95% confidence interval (CI), 14.7-26.1%] of patients exhibited dNCR 1-week post-surgery. Longer LTL was identified as a predictor for the onset of early cognitive impairment resulting in postoperative cognitive decline [odds ratio (OR), 14.82; 95% CI, 4.01-54.84; P < 0.001], following adjustment of age (OR, 12.33; 95% CI, 3.29-46.24; P < 0.001). The dNCR incidence based on LTL values of these patients, the area under the receiver operating characteristic (ROC) curve was 0.79 (95% CI, 0.722-0.859; P < 0.001). At an optimal cut-off value of 0.959, LTL values offered respective specificity and sensitivity values of 64.7% and 87.5%.

Conclusions: In summary, the current study revealed that the incidence of dNCR was strongly associated with prolonged LTL. Furthermore, this biomarker could help identify high-risk patients and offer insight into the pathophysiology of dNCR.

Keywords: Aging; Delayed neurocognitive recovery; Telomere length.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of peripheral blood LTL between the dNCR group and non- dNCR group. The median (interquartile range) LTL was markedly lengthier in patients who developed dNCR than in those who did not. **P < 0.001
Fig. 2
Fig. 2
ROC curve for incidence prediction of dNCR in elderly patients following non-cardiac surgery. ROC curve analysis was performed for the LTL with dNCR. The area under the ROC curve of the duration of the LTL in the dNCR group was 0.791 (95% CI, 0.722–0.859). The optimal cut-off value was 0.959, with a sensitivity of 87.5% and a specificity of 64.7%
Fig. 3
Fig. 3
Comparison of the incidence of dNCR between long LTL group and short LTL group. All patients in the experimental group were categorized into the short LTL group and the long LTL group by the LTL median. The incidence of dNCR was compared between the two groups one week after the operation. The incidence of dNCR in the long LTL group was 7-fold higher than that in the short LTL group. **P < 0.001
See this image and copyright information in PMC

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