Relationships between adiponectin and matrix metalloproteinase-9 (MMP-9) serum levels and postoperative cognitive dysfunction in elderly patients after general anesthesia

OBJECTIVE The aim of this study was to evaluate the relationships between the serum levels of adiponectin (ADP) and matrix metalloproteinase-9 (MMP-9) and postoperative cognitive dysfunction (POCD) in elderly patients after general anesthesia. METHODS The cognitive functions of 98 elderly patients who were scheduled to undergo selective hip replacement surgery under general anesthesia were assessed using the Montreal Cognitive Assessment (MoCA) 3 days before surgery and on postoperative Days 1, 2, 3, and 7. The serum levels of ADP and MMP-9 were determined at the same time points, and the presence of POCD on postoperative Day 3 was recorded. The patients were divided into a POCD group and non-POCD group. RESULTS Postoperative cognitive dysfunction was observed in 28 patients (28.5 %). Serum MMP-9 levels significantly increased and serum ADP levels significantly decreased in the POCD group at each postoperative time point and in the non-POCD group on postoperative Days 1 and 2 compared to the presurgical levels. Serum MMP-9 levels were significantly higher and serum ADP levels were significantly lower in the POCD group compared with those in the non-POCD group at each time point. In the POCD patients, serum MMP-9 levels were significantly and negatively correlated and serum ADP levels were significantly and positively correlated with the MoCA scores. CONCLUSIONS The increased serum MMP-9 levels and decreased serum ADP levels in elderly patients after general anesthesia might be involved in the POCD pathophysiological process.