Diabetes Prevalence and Clinical Correlates in Hospitalized Heart Failure Patients in China

BackgroundHeart failure (HF) and diabetes frequently coexist and are associated with worse outcomes, yet contemporary evidence on the prevalence and clinical correlates of diabetes in hospitalized patients with HF in China remains limited.MethodsData for this study were obtained from Zigong Fourth People’s Hospital. A total of 2,008 adults hospitalized with HF were included, of whom 466 had diabetes. Demographic, clinical, hemodynamic and laboratory variables were extracted from the first admission records. We estimated the prevalence of diabetes and used univariate and multivariable logistic regression to identify factors associated with diabetes. Machine learning models were applied to rank variable importance, and restricted cubic splines were used to explore the shapes of these associations. Sex- and age-stratified analyses were further conducted to assess heterogeneity.ResultsThe prevalence of diabetes among hospitalized patients with HF was 23.21% (95% CI: 21.39–25.13). In multivariable models, female sex, higher systolic blood pressure, statin use, elevated white blood cell (WBC) count, and higher serum potassium were associated with greater odds of diabetes, whereas higher high-density lipoprotein cholesterol (HDL-C) was inversely associated with diabetes (OR = 0.53, 95% CI: 0.37–0.76). WBC, potassium and HDL-C consistently ranked among the top contributors in both machine learning models. Restricted cubic splines revealed a nonlinear association between WBC count and diabetes, while potassium and HDL-C showed monotonic relationships. In stratified analyses, potassium and HDL-C remained associated with diabetes in females and in patients aged ≥70 years.ConclusionIn Chinese inpatients with HF, approximately one in four had concomitant diabetes. WBC count, blood pressure, potassium and HDL-C were associated with diabetes status, with some variation across sex and age groups. These findings provide additional evidence on the clinical characteristics associated with diabetes in hospitalized patients with HF.