Relationship of two serum markers with disease severity in elderly patients with diabetes mellitus complicated with dementia

LI Xia; GONG Shaoyun; ZHANG Fei; ZHENG Jianjun

doi:10.3969/j.issn.1009-0126.2026.01.016

Abstract：Objective To investigate the correlation between serum NOD-like receptor thermal protein domain associated protein 3(NLRP3)and cysteine aspartate protease-1(Caspase-1)and disease severity of elderly diabetes mellitus(DM)patients with concomitant dementia.Methods A total of 120 elderly eligible patients admitted in our department from January 2023 to January 2025 were enrolled,and according to the results of mini-mental state examination(MMSE),they were divided into mild(43 cases),moderate(39 cases)and severe dementia group(38 cases).Another 56 patients with simple DM who received MMSE screening during the same period were enrolled as the control group.General data were collected,including hemoglibin A1c(HbA1c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and very low-density lipoprotein cholesterol(VLDL-C).The levels of NLRP3 and Caspase-1 were detected with enzyme-linked immunosorbent assay(ELISA).Spearman correlation analysis was used to analyze the correlation between NLRP3 and Caspase-1 levels and disease severity in the patients.Multivariate logistic regression analysis was employed to identify the influencing factors for elderly DM complicated with dementia.ROC curve was plotted to analyze the diagnostic value and calculate the area under the curve(AUC)of the two markers.Results The levels of fasting plasma glucose(FPG),HbAlc,TC,TG,LDL-C,VLDL-C,NLRP3 and Caspase-1 were significantly higher,while the HDL-C level was obviously lower in the moderate and severe dementia groups than the control group and the mild dementia group(P<0.05),and similar results were observed in the severe dementia group when compared with the moderate dementia group(P<0.05).Spearman correlation analysis suggested that the serum NLRP3 and Caspase-1 levels were positively correlated with disease severity of elderly DM patients with dementia(r=0.594,P=0.013;r=0.517,P=0.019).Multivariate logistic regression analysis identified that serum NLRP3,Caspase-1,FPG,HbAlc,TC,LDL-C and VLDL-C were risk factors of dementia in elderly patients with DM,and HDL-C was a protective factor(P<0.05,P<0.01).The AUC value of combining serum NLRP3 and Caspase-1 levels together in diagnosing elderly DM patients with dementia in was significantly higher than that of single marker(0.862 vs 0.853 and 0.771,P<0.01).Conclusion Serum NLRP3 and Caspase-1 levels are independent risk factors of elderly DM with dementia,and the indicators can be used as biomarkers for diagnosing disease severity and assisting clinical analysis of prognosis.