A cross-sectional study on the impact of NLRP3 and FGF23 levels on atherosclerotic cardiovascular disease in elderly diabetic patients

Introduction
Atherosclerotic cardiovascular disease (ASCVD) is a major cause of mortality and disability in elderly patients with diabetes.

Aim
We aimed to investigate the impact of serum NOD-like receptor protein 3 (NLRP3) and fibroblast growth factor 23 (FGF23) on ASCVD in elderly diabetic patients.

Material and methods
A total of 130 elderly diabetic patients and 60 healthy controls were enrolled, and serum NLRP3 and FGF23 levels were measured. Logistic regression analysis and ROC curves were applied to assess the influencing factors.

Results
Fasting blood glucose and diabetes duration were higher or longer in the ASCVD group than in the diabetes group (all p < 0.001). The levels of NLRP3 and FGF23 were higher in the ASCVD group than in the diabetic group (all p < 0.001). Serum NLRP3, FGF23, fasting blood glucose, and duration of diabetes were independent influences on the occurrence of ASCVD in elderly diabetic patients (p = 0.001, < 0.001, 0.005, < 0.001). The AUC of the combined test was 0.887 (95% CI: 0.827–0.947), which was superior to that of the individual tests (NLRP3 AUC = 0.732 (95% CI: 0.646–0.818), FGF23 AUC = 0.861 (95% CI: 0.791–0.932)).

Conclusions
The levels of FGF23 and NLRP3 are associated with the occurrence and development of ASCVD in elderly diabetic patients. Elevated levels of NLRP3 and FGF23 may be influencing factors for ASCVD in elderly diabetic patients. The failure to include potential confounding factors such as eGFR is a major limitation of this study.