The predictive value of fecal S-adenosylmethionine and glucose-1-phosphate in elderly patients with diabetes mellitus complicated by heart failure

WANG Jinxin; CHENG Xiaowei; WANG Haijun; MA Jinling; ZHANG Li; LIU Hongbin

doi:10.3969∕j.issn.1674-3245.2026.02.003

Abstract：Objective To investigate the clinical characteristics and predictors of heart failure in elderly patients with diabetes mellitus.Methods This study constitutes a retrospective analysis,wherein 22 patients diagnosed with type 2 diabetes mellitus complicated by heart failure,who were treated at the Second Medical Center of PLA General Hospital between January and December 2022,were designated as the observation group.A control group was established by age-and sex-matched selection of 37 diabetes patients without cardiac structural or functional abnormalities who underwent routine health examinations during the same period.Clinical data and stool specimens were collected from both groups.Concentrations of S-adenosylmethionine and glucose-1-phosphate were measured by liquid chromatography-mass spectrometry(LC-MS).Potential predictors were analyzed by univariate comparisons between groups and multivariate logistic regression.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive value of individual and combined predictors for heart failure in elderly patients with diabetes.Results Compared with the control group,the observation group had lower levels of S-adenosylmethionine[2.26(0.19,3.15)nmol∕g vs.61.51(14.83,99.02)nmol∕g]and glucose-1-phosphate[0.67(0.47,2.39)nmol∕g vs.2.85(2.01,8.15)nmol/g],respectively(Z=-4.655,-4.702,P<0.001).In multivariate analysis,S-adenosylmethionine(odds ratio OR=0.975,95％CI:0.952～0.998,P=0.036)and Glucose-1-phosphate(OR=0.262,95％CI:0.094～0.727,P=0.010)were independent predictors of heart failure in elderly patients with diabetes.ROC analysis showed that the combined prediction using both markers yielded an area under the curve(AUC)of 0.937(P<0.001),with a sensitivity of 95.5％and a specificity of 83.8％.Conclusion S-adenosylmethionine and glucose-1-phosphate are independent predictors of heart failure in elderly patients with diabetes.The combined use of these two markers has high predictive value.