Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.05.014
Brazilian Journal of Anesthesiology
Clinical Research

Association between telomere length in the DNA of peripheral blood leukocytes and the propofol dose in anesthesia induction: an observational study

Yan Xu, Chuang Bo Xie, Jing Yang, Yong Ji Xing, Wei Ping Xia, Yang Liu, Wen Bin Xi, Zhao Ju Li, Wei Feng Tu, Jun Long Zhang

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Abstract

Introduction
Propofol is a widely used anesthetic and its dose is closely related to aging. Telomere length (TL) is a unique heritable trait, and emerging as a biomarker of aging, health and disease. Telomerase RNA component (TERC) plays an important role in maintaining TL. We proposed a hypothesis that propofol dose in general anesthesia can be predicted by measuring TL before operation, which greatly reduced the risk of anesthesia, especially the elderly.

Methods
The association between the propofol dose in anesthesia induction and: TL in the DNA of peripheral blood leukocytes; body weight; sex;difference of the Bispectral Index (BIS) before and after anesthesia induction in patients was evaluated by multivariable linear regression analyses. The mutation at the 5′end or 3′end of TERC was detected. We recruited 100 patients of elective surgery.

Results
We found that propofol dose in anesthesia induction was clearly correlated significantly with TL (r = 0.78, p <  0.001), body weight (r = 0.84, p =  0.004), sex (r = 0.83, p = 0.004), and difference of BIS before and after anesthesia induction (r = 0.85, p =  0.029). By comparing the absolute values of standardized regression coefficients (0.58, 0.21, 0.19, and 0.12) of the four variables, it can be seen that TL contributes the most to the propofol dose in anesthesia induction. However, the mutation at the 5′ end or 3′ end of TERC was not found.

Conclusions
These findings provide preliminary evidence that the propofol dose in anesthesia induction was clearly correlated with genetically determined TL. TL may be a promising predictor of the propofol dose, which is beneficial to improve the safety of anesthesia and reduce perioperative complications.

Keywords

Telomere length;  Propofol dose;  Anesthesia safety;  Perioperative complications

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