ArticleAging clinical and experimental research2023
Association of insulin resistance with delirium and CSF biomarkers of Alzheimer's disease in elderly patients with hip fracture.
Article in Aging clinical and experimental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- The role of diabetes mellitus on delirium onset: a systematic review and meta-analysis.Cardiovascular diabetology · 2025 · on this mapPooled it
- Cerebrospinal fluid biomarkers of neuroinflammation and postoperative neurocognitive disorders in patients undergoing orthopedic surgery: a systematic review and meta-analysis.International journal of surgery (London, England) · 2025Pooled it
- Long-acting intranasal insulin for the treatment of delirium-a randomised clinical trial.Age and ageing · 2025Trial
- Intranasal Insulin Diminishes Postoperative Delirium and Elevated Osteocalcin and Brain Derived Neurotrophic Factor in Older Patients Undergoing Joint Replacement: A Randomized, Double-Blind, Placebo-Controlled Trial.Drug design, development and therapy · 2025Trial
- Atherogenic Index of Plasma for the Prediction of Delirium in ICU Patients: A Retrospective Cohort Study Based on the MIMIC-IV Database.Brain and behavior · 2026Article
- Association between triglyceride-glucose index and postoperative delirium following cardiac surgery: a multicenter retrospective analysis.Lipids in health and disease · 2025Article
- Emerging biomarkers of postoperative delirium at the intersection of neuroinflammation and neurodegeneration.Frontiers in aging neuroscience · 2025Review
- Association of triglyceride-glucose index and delirium in patients with sepsis: a retrospective study.Lipids in health and disease · 2024Article
- Association between preoperative persistent hyperglycemia and postoperative delirium in geriatric hip fracture patients.BMC geriatrics · 2024Article
- Association of peripheral B cells and delirium: combined single-cell sequencing and Mendelian randomization analysis.Frontiers in neurology · 2024Article
- Triglyceride-glucose index as a valuable predictor for aged 65-years and above in critical delirium patients: evidence from a multi-center study.BMC geriatrics · 2023Article
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6 authors at 2 institutions in 1 country.
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Abstract
backgroundDelirium is associated with dementia, which shares symptoms of cognitive dysfunctions. Notably, pathological mechanisms of Alzheimer's disease (AD) appear involved in both conditions. Insulin resistance has been reported to be a risk factor for AD, leading to neurodegeneration and cognitive impairment by affecting amyloid-beta (Aβ) metabolism, tau phosphorylation, and neuro-inflammation. Thus, insulin resistance may provide pathophysiological clues to the occurrence of delirium.
aimTo investigate the relationship between preoperative insulin resistance, insulin concentrations in the cerebrospinal fluid (CSF), and delirium in elderly patients with hip fracture.
methodsThe study included 138 elderly patients with or without pre-existing dementia who underwent hip fracture surgery. Delirium was diagnosed with the confusion assessment method performed daily from pre-operation to 5 days post-operation. CSF and blood samples were collected at the beginning of spinal anesthesia. The concentrations of insulin, amyloid-beta1-42 (Aβ42), total tau (t-tau), and phosphorylated tau (p-tau)
resultsSixty-one (44%) of 138 hip fracture patients developed delirium peri-operatively. Compared to non-delirium group, the preoperative HOMA-IR index in delirium was much higher (median 3.3 vs 2.8, p = 0.001), but the CSF insulin concentration was significantly decreased (median 1.5 vs 2.2 mU/L, p < 0.001). Binary logistic regression analysis showed that HOMA-IR index and CSF insulin concentration were independent risk factors for delirium (p < 0.05). HOMA-IR index was negatively correlated with CSF insulin concentrations (rho = - 0.55, p < 0.001). Multiple linear regression analysis showed that AD core biomarkers were significantly correlated with HOMA-IR index and CSF insulin level (p < 0.05).
conclusionThis study innovatively examined insulin concentrations in serum and cerebrospinal fluid in patients with delirium. Our findings suggest that preoperative insulin resistance may affect the occurrence of delirium. The potential association between insulin resistance and delirium may be related to insulin resistance affecting the metabolism of AD biomarkers.
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