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This research aims at describing the relationship between white adipose tissue inflammation and post-operative cognitive dysfunctions.The possible link between inflammatory cytokines secretions of the white adipose tissue of a surgical wound and the arising of patient's cognitive dysfunction in the post-operative course will be investigated. The hypothesis is that obese patient's inflammation of the white adipose tissue leads to cognitive dysfunction.
The postoperative cognitive dysfunctions (POCD) are characterized by delirium and cognitive impairment. The delirium is defined by an acute altered attention with a fluctuating course. The post-operative cognitive impairment involves the early alteration of different functions including memory, attention and cognitive flexibility. POCD have a major impact in patient's morbidity. They are linked to the systemic inflammation induced by the surgical wound. The systemic inflammation leads to the rupture of the brain-blood barrier and to hippocampal inflammation. As hippocampus mediates the principal cognitive functions, hippocampal inflammation leads to POCD. Orthopedic and cardiac surgery are particularly concerned. Obesity is growing condition in the French population. It is linked to chronic systemic inflammation and altered cognitive functions. We think that obese people may present a susceptibility to POCD because of the pre-operative systemic inflammation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Obese patients | BMI >30kg/m2 |
| |
| non obese patients | BMI between 18 to 29kg/m2 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blood sampling | Biological | 4 tubes of 7 mL of blood will be collected |
|
| Measure | Description | Time Frame |
|---|---|---|
| Arising of POCD measured by a composite criterion | 2 points Mini-Mental State Examination (MMSE) score decrease compared to the pre-operative score, and/or appearance of a delirium tracked down every day by the Confusion Assessment Method (CAM) during the hospital course. | day 5 after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Variation of inflammatory cytokine levels from patient's plasma and patient's white adipose tissue (extract from a controlled medium). | inflammatory cytokine levels will be measured in plasma and adipose tissue, and compared. | Day 0 and day 5 after surgery |
| Identification of a linked between inflammatory cytokine levels and the appearance of POCD. |
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Inclusion Criteria:
Exclusion Criteria:
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prospective, monocentric study conduct in Toulouse university hospital
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| Name | Affiliation | Role |
|---|---|---|
| François Labaste, MD, PhD | University Hospital, Toulouse | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Purpan University Hospital | Toulouse | 31059 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40424308 | Result | Pey V, Stephan M, Gros P, Dray C, Bounes F, Marcheix B, Minville V, Galinier A, Labaste F. Assessment of arterial whole blood redox potential during cardiopulmonary bypass. PLoS One. 2025 May 27;20(5):e0324437. doi: 10.1371/journal.pone.0324437. eCollection 2025. |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| D060825 | Cognitive Dysfunction |
| D007249 | Inflammation |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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Blood samples and white adipose tissues
| white adipose tissue sampling | Biological | At the beginning of the surgery, samples of white adipose tissue from the surgical wound will be collected. |
|
inflammatory cytokine levels will be measured in plasma and adipose tissue, and correlated with appearance of POCD |
| day 5 after surgery |
| Peri-operative variations of the protein S100B, an autonomy scale (IADL) and a quality of life scale (EQ5D). | protein S100B levels will be measured in plasma and adipose tissue, and correlated with scores of autonomy scale (IADL) and quality of life scale (EQ5D). | day 5 after surgery |
| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D010335 | Pathologic Processes |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |