Does the melatonin receptor 1B gene polymorphism have a role in postoperative delirium?

作者：Elizabeth Mahanna, Todd A. Miano, John Augoustides, Cecilia Kim, Joseph E. Bavaria, W. Andrew Kofke · 发表于：PLoS ONE · 年份：2018 · DOI：10.1371/journal.pone.0207941 · 被引用次数：16 · 研究领域：Circadian rhythm and melatonin、Climate Change and Health Impacts、Thermal Regulation in Medicine

INTRODUCTION: Patients undergoing cardiac surgery are at high risk for postoperative delirium, which is associated with longer hospital and intensive care lengths of stays, increased morbidity and mortality. Because sleep disturbances are common in delirium, melatonin has been an area of interest in the treatment of delirium. The rs10830963 single nucleotide polymorphism of the melatonin receptor 1B gene can cause pathological dysfunction of this receptor and is associated with delayed morning offset of melatonin. We hypothesized patients undergoing aortic cardiac surgery who have the risk genotype of a melatonin receptor 1B polymorphism would have a higher incidence of postoperative delirium. METHODS: Ninety-eight patients undergoing aortic root or valve surgery underwent analysis for melatonin receptor 1B single nucleotide polymorphism, rs10830963. Using a validated method, CHART-DEL, all charts were retrospectively reviewed and scored for the presence of delirium while blinded to the results of the melatonin receptor 1B gene polymorphism. RESULTS: Genotyping for melatonin receptor 1B polymorphism was acceptable in 76 subjects of European descent of which 18 (23.7%) had delirium. Four of seven subjects with the risk genotype had delirium versus only 20.3% of subjects without the risk genotype. This carried an odds ratio of 5.2 (1.0, 26.1), p = 0.050. CONCLUSION: This observation suggests a role of the risk genotype of a melatonin receptor 1B polymorphism in the development ...