Temporal Variability in Inflammatory Gene Methylation and Delirium in Critically Ill Patients.
Background: Intensive care unit (ICU) delirium is associated with a proinflammatory state and poor outcomes. An epigenetic mechanism may modify inflammation. Objective: To identify inflammatory gene methylation trajectory groups and explore their clinical and demographic variability. Methods: Patien...
| Published in: | American Journal of Critical Care Vol. 31; no. 5; pp. 367 - 375 |
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| Main Authors: | , , , , |
| Format: | research Journal Article |
| Published: |
American Association of Critical-Care Nurses
Sep2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=158812731&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 158812731 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10623264 44L jtl: American Journal of Critical Care issn: 10623264 maglogo: N pubinfo: dt: Sep2022 vid: 31 iid: 5 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 158812731 158812731 158812731 10.4037/ajcc2022225 158812731 ppf: 367 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Temporal Variability in Inflammatory Gene Methylation and Delirium in Critically Ill Patients. aug: au: Alexander, Sheila A. Conley, Yvette P. Girard, Timothy D. McVerry, Bryan J. Ren, Dianxu affil: Sheila A. Alexander is an associate professor of nursing, University of Pittsburgh, Pittsburgh, Pennsylvania sug: subj: Genes DNA Methylation Evaluation Inflammation Delirium Critically Ill Patients Sociodemographic Factors Human Adolescence Young Adult Adult Respiration, Artificial Confusion Intensive Care Units Structural Equation Modeling Descriptive Statistics White Persons Sex Factors Nonexperimental Studies Prospective Studies Female Male Data Analysis Software Chi Square Test Adolescent: 13-18 years Adult: 19-44 years Female Male ab: Background: Intensive care unit (ICU) delirium is associated with a proinflammatory state and poor outcomes. An epigenetic mechanism may modify inflammation. Objective: To identify inflammatory gene methylation trajectory groups and explore their clinical and demographic variability. Methods: Patients were at least 18 years old; received mechanical ventilation for at least 24 hours; had no brain disorder/injury, preexisting dementia, or positive toxicology screen; and were admitted to a medical or surgical/trauma ICU. Delirium was assessed (Confusion Assessment Method for the ICU) and blood samples were collected daily for up to 10 days. Methylation of 3 genes in the inflammatory pathway was quantified. Latent class analysis identified gene methylation trajectories, and variables (including delirium) were compared between trajectory groups. Results: Of 68 patients (53% female, 88% White), 65% developed delirium. Of 3 methylation trajectories for IL6ST, the group with low initial methylation increasing over time included younger male patients who were less likely to have delirium, and the group with high initial methylation decreasing over time included older (P =.01) female (P =.05) patients who more often had delirium (P =.05). IL17C had 2 methylation trajectories without significant differences in delirium, age, or sex. IL13RA1 had 2 methylation trajectories without differences in delirium or age; the group with sustained high methylation had more female patients (P =.003). Conclusions: Temporal variability in inflammatory gene methylation occurs after ICU admission. Delirium, female sex, and older age were more common with higher IL6ST methylation that decreased over time. Larger studies are needed to further elucidate these relationships. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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