Metabolomics Reveals Glyoxylate and Dicarboxylate Metabolism Disorder in Elderly Trauma: A Retrospective Study

BACKGROUND: Elderly trauma (ET) carries a high mortality rate due to comorbidities, frailty, and limited physiological reserve. Understanding its specific pathophysiology is essential for enabling precision treatment. OBJECTIVE: To identify characteristic metabolic dysregulations and specific pathways in geriatric trauma. METHODS: We retrospectively analyzed existing metabolomics data from ET, young and middle-aged trauma (YMAT), elderly controls (EC), and young and middle-aged controls (YMAC). RESULTS: An IVD integrating 8 significant metabolic pathways (SMPs) from ET vs EC and 10 SMPs from YMAT vs YMAC identified 3 pathways specific to ET: glyoxylate and dicarboxylate metabolism, galactose metabolism, and Pantothenate and coenzyme A (CoA) biosynthesis. The second IVD integrating these pathways with 3 SMPs from EC vs YMAC identified 2 metabolic pathways specific to ET independent of natural aging: glyoxylate and dicarboxylate metabolism, and pantothenate and CoA biosynthesis. Finally, the third IVD integrating them and 7 SMPs from ET vs YMAT identified glyoxylate and dicarboxylate metabolism as unique signature of geriatric trauma. CONCLUSION: This study was one of few metabolomics studies that distinguish between geriatric trauma-related metabolic changes and baseline aging factors, and revealed glyoxylate and dicarboxylate metabolism disorder as a key pathway specific to geriatric trauma. Understanding it may inform the development of age-tailored strategies for improving trauma outcomes in the elderly.