Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery

BackgroundPostoperative delirium (POD) is a serious neuropsychiatric complication in elderly surgical patients, yet its pathogenesis remains incompletely understood. Transfer RNA-derived small RNAs (tsRNAs) have emerged as crucial regulators in neurological disorders. We investigated whether specifi...

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Main Authors: Angyang Cao, Rui Zhao, Chunqu Chen, Can Wu, Yiwei Zhang, Changshun Huang, Binbin Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1522984/full
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author Angyang Cao
Angyang Cao
Rui Zhao
Rui Zhao
Chunqu Chen
Chunqu Chen
Can Wu
Can Wu
Yiwei Zhang
Yiwei Zhang
Changshun Huang
Changshun Huang
Binbin Zhu
Binbin Zhu
author_facet Angyang Cao
Angyang Cao
Rui Zhao
Rui Zhao
Chunqu Chen
Chunqu Chen
Can Wu
Can Wu
Yiwei Zhang
Yiwei Zhang
Changshun Huang
Changshun Huang
Binbin Zhu
Binbin Zhu
author_sort Angyang Cao
collection DOAJ
description BackgroundPostoperative delirium (POD) is a serious neuropsychiatric complication in elderly surgical patients, yet its pathogenesis remains incompletely understood. Transfer RNA-derived small RNAs (tsRNAs) have emerged as crucial regulators in neurological disorders. We investigated whether specific tsRNAs could serve as predictive biomarkers for POD.MethodsThis study conducted a prospective case-control study of 158 elderly patients (≥60 years) undergoing orthopedic surgery. Plasma samples were collected preoperatively and on postoperative day 3.tsRNA expression profiles were analyzed using RNA sequencing and validated by RT-qPCR. Propensity score matching was performed to balance demographic and clinical variables. The predictive value of candidate tsRNAs was assessed using ROC analysis, and their potential functions were explored through bioinformatic analyses.ResultsAmong 128 non-POD and 30 POD patients, two tsRNAs (Other-14: 31-tRNA-Gly-CCC-3 and Other-39: 73-tRNA-Arg-TCG-5) showed significantly elevated preoperative levels in POD patients (p<0.001).ROC analysis revealed strong predictive performance (AUC=0.868 and 0.956, respectively).These differences persisted in the propensity-matched cohort (29 pairs).Bioinformatic analyses indicated enrichment in pathways related to neurotransmission, inflammation, and metabolism.ConclusionThis study identified novel tsRNA biomarkers that robustly predict POD risk and provide insights into its molecular pathogenesis. These findings may facilitate early risk stratification and preventive interventions.
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publishDate 2025-03-01
publisher Frontiers Media S.A.
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series Frontiers in Psychiatry
spelling doaj-art-3f1c1edbbafd47b69e718868bb26fdb32025-08-20T03:40:41ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-03-011610.3389/fpsyt.2025.15229841522984Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgeryAngyang Cao0Angyang Cao1Rui Zhao2Rui Zhao3Chunqu Chen4Chunqu Chen5Can Wu6Can Wu7Yiwei Zhang8Yiwei Zhang9Changshun Huang10Changshun Huang11Binbin Zhu12Binbin Zhu13Department of Anesthesiology, The First Affliated Hospital of Ningbo University, Ningbo, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaDepartment of Anesthesiology, The First Affliated Hospital of Ningbo University, Ningbo, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaDepartment of imaging, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaDepartment of Clinical laboratory, Jinhua Maternal and Child Health Care Hospital, Jinhua, ChinaDepartment of Anesthesiology, The First Affliated Hospital of Ningbo University, Ningbo, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaDepartment of Anesthesiology, The First Affliated Hospital of Ningbo University, Ningbo, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaDepartment of Anesthesiology, The First Affliated Hospital of Ningbo University, Ningbo, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaBackgroundPostoperative delirium (POD) is a serious neuropsychiatric complication in elderly surgical patients, yet its pathogenesis remains incompletely understood. Transfer RNA-derived small RNAs (tsRNAs) have emerged as crucial regulators in neurological disorders. We investigated whether specific tsRNAs could serve as predictive biomarkers for POD.MethodsThis study conducted a prospective case-control study of 158 elderly patients (≥60 years) undergoing orthopedic surgery. Plasma samples were collected preoperatively and on postoperative day 3.tsRNA expression profiles were analyzed using RNA sequencing and validated by RT-qPCR. Propensity score matching was performed to balance demographic and clinical variables. The predictive value of candidate tsRNAs was assessed using ROC analysis, and their potential functions were explored through bioinformatic analyses.ResultsAmong 128 non-POD and 30 POD patients, two tsRNAs (Other-14: 31-tRNA-Gly-CCC-3 and Other-39: 73-tRNA-Arg-TCG-5) showed significantly elevated preoperative levels in POD patients (p<0.001).ROC analysis revealed strong predictive performance (AUC=0.868 and 0.956, respectively).These differences persisted in the propensity-matched cohort (29 pairs).Bioinformatic analyses indicated enrichment in pathways related to neurotransmission, inflammation, and metabolism.ConclusionThis study identified novel tsRNA biomarkers that robustly predict POD risk and provide insights into its molecular pathogenesis. These findings may facilitate early risk stratification and preventive interventions.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1522984/fulltsRNApostoperative delirium (POD)RT-qPCRelderly patientspropensity score matching (PSM)
spellingShingle Angyang Cao
Angyang Cao
Rui Zhao
Rui Zhao
Chunqu Chen
Chunqu Chen
Can Wu
Can Wu
Yiwei Zhang
Yiwei Zhang
Changshun Huang
Changshun Huang
Binbin Zhu
Binbin Zhu
Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery
Frontiers in Psychiatry
tsRNA
postoperative delirium (POD)
RT-qPCR
elderly patients
propensity score matching (PSM)
title Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery
title_full Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery
title_fullStr Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery
title_full_unstemmed Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery
title_short Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery
title_sort circulating tsrnas serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery
topic tsRNA
postoperative delirium (POD)
RT-qPCR
elderly patients
propensity score matching (PSM)
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1522984/full
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