ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1678453
This article is part of the Research TopicPrecision Strategies for Atrial Fibrillation: Diagnosis, Risk, and Treatment InnovationsView all 6 articles
A preliminary study on the early warning role of DL-malic acid in atrial fibrillation occurrence among patients with hyperuricemia
Provisionally accepted
- 1First Clinical Medical College, Shandong University of Traditional Chinese Medicine, No. 42, Wenhua East Road, Lixia District, Jinan, Shandong, People’s Republic of China, China
- 2Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
- 3Shandong First Medical University, Jinan, China
- 4Jining No 1 People's Hospital, Jining, China
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Background: There have been sufficient previous studies demonstrating that hyperuricemia (HUA) is closely associated with the occurrence of atrial fibrillation (AF).The incidence of AF in patients with hyperuricemia is higher than that in the general population. Therefore, it is meaningful to explore the serum markers of AF in the HUA population and establish early warning indicators. Objective: To preliminarily explore the correlation between HUA and AF at the metabolomics level, and to identify a group of metabolites with potential predictive power for AF that can be used for further large-scale studies. Methods: This study used untargeted metabolomics technology to detect serum metabolites of patients with AF, patients with AFHUA, and control group. Receiver operator characteristic (ROC) curve were used to analyze differential metabolites. Results: Ultimately, multiple metabolites such as L-Threonine, DL-Malic acid, L-Valine , L-Cysteine were identified as early warning markers of AF in patients with HUA.Combined ROC curve using these four metabolites between the AFHUA/Control comparison group and the AFHUA/AF comparison group showed good predictive efficacy, with Area Under the ROC Curve (AUC)=0.923 (P<0.001) in the AFHUA/Control comparison group and AUC=0.714 (P<0.001) in the AFHUA/AF comparison group.This provides an early predictive method for patients who may develop atrial fibrillation among those with hyperuricemia.And offers new approaches for the prevention and treatment of atrial fibrillation. Conclusion: This study indicates that serum metabolomics can be specifically used to predict the probability of AF occurrence in individuals with HUA, and has identified metabolites such as L-Threonine, DL-Malic acid, L-Valine, and L-Cysteine that possess potential predictive efficacy.
Keywords: Hyperuricemia, Atrial Fibrillation, Metabolomics, biomarker, Early warning indicators
Received: 02 Aug 2025; Accepted: 26 Sep 2025.
Copyright: © 2025 Li, Jiao, Liu, Li, Lv, Jin and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huachen Jiao, liyixuan0531@163.com
Donghai Liu, liudonghai@sdfmu.edu.cn
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