Diagnostic value of combined serum protein carbonyl, 8-hydroxy-2'-deoxyguanosine, and PGC-1a detection for myocardial energy metabolism disorder in ischemic cardiomyopathy

Background: Patients with ischemic cardiomyopathy (ICM) often have abnormalities in myocardial energy metabolism, whereas conventional cardiac function indices, such as left ventricular ejection fraction (LVEF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), may not capture metabolic injury with sufficient sensitivity. This study aimed to evaluate the diagnostic value of the combined detection of serum protein carbonyl (PC), 8-hydroxy-2'-deoxyguanosine (8-OHdG), and peroxisome proliferator-activated receptor gamma coactivator-1 Alpha (PGC-1a) for myocardial energy metabolism disorder in patients with ICM. Methods: In this single-centre retrospective study, a total of 167 patients with ICM from June 2024 to October 2025 were enrolled. According to myocardial energy metabolism status, they were divided into an energy metabolism disorder group (n=78) and a non-disorder group (n=89). Serum PC, 8-OHdG, and PGC-1a levels were measured. Clinical data, cardiac function indices, and serum biomarker levels were compared between the two groups. A combined diagnostic model was then constructed using logistic regression, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of single indicators and combined detection. Results: Compared with the non-disorder group, the energy metabolism disorder group showed increased PC and 8-OHdG levels and decreased PGC-1a levels; specifically, PC increased by approximately 38%, 8-OHdG increased by approximately 41%, and PGC-1a decreased by approximately 24%, with statistically significant differences (P<0.001). Multivariate logistic regression showed that PC, 8-OHdG, and PGC-1a were independently associated with myocardial energy metabolism disorder. ROC analysis showed that the areas under the curve (AUCs) of PC, 8-OHdG, and PGC-1a alone were 0.806, 0.791, and 0.772, respectively. The AUC of the combined diagnostic score increased to 0.884, with a sensitivity of 87.18% and a specificity of 79.78%, and the AUC of the combined model was higher than that of every single indicator. Conclusion: Increased serum PC and 8-OHdG levels and decreased PGC-1a levels are closely related to myocardial energy metabolism disorder in patients with ICM. Combined detection of the three indicators demonstrates good diagnostic performance. It may provide laboratory evidence for early-stage auxiliary identification and risk stratification of myocardial energy metabolism disorders.