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刘明玉, 李佳, 张鹏鑫, 程雅欣, 谭文彬, 李红梅, 李书稳, 朱凯旋, 杨柳, 蒋雪松, 郗佳奇. 糖尿病与听力下降的相关性的回顾性病例对照研究[J]. 解放军医学院学报. DOI: 10.12435/j.issn.2095-5227.2023.157
引用本文: 刘明玉, 李佳, 张鹏鑫, 程雅欣, 谭文彬, 李红梅, 李书稳, 朱凯旋, 杨柳, 蒋雪松, 郗佳奇. 糖尿病与听力下降的相关性的回顾性病例对照研究[J]. 解放军医学院学报. DOI: 10.12435/j.issn.2095-5227.2023.157
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LIU Mingyu, LI Jia, ZHANG Pengxin, CHENG Yaxin, TAN Wenbin, LI Hongmei, LI Shuwen, ZHU Kaixuan, YANG Liu, JIANG Xuesong, XI Jiaqi. Association between diabetes and hearing loss: A retrospective case control study[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL. DOI: 10.12435/j.issn.2095-5227.2023.157
Citation: LIU Mingyu, LI Jia, ZHANG Pengxin, CHENG Yaxin, TAN Wenbin, LI Hongmei, LI Shuwen, ZHU Kaixuan, YANG Liu, JIANG Xuesong, XI Jiaqi. Association between diabetes and hearing loss: A retrospective case control study[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL. DOI: 10.12435/j.issn.2095-5227.2023.157
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糖尿病与听力下降的相关性的回顾性病例对照研究

Association between diabetes and hearing loss: A retrospective case control study

    摘要
  • 摘要:
    背景 听力下降为糖尿病的并发症之一，但目前重视程度较其它并发症低，且各指南较少提及糖尿病听力下降问题。
    目的 本研究旨在探讨糖尿病与听力下降的相关性。
    方法 收集 2022年9月至2023年3月在解放军南部战区总医院内分泌科住院的糖尿病患者222例，根据是否患有听力下降分为听力正常组和听力下降组。采用有序多分类Logistic回归分析评价糖尿病患者听力下降严重程度的相关危险因素。
    结果 共纳入222例糖尿病患者，其中听力下降组和听力正常组分别为165例和57例。听力下降组和听力正常组均以男性居多，听力下降组男性95例(57.6%)，听力正常组男性38例(66.7%)，两组之间的差异无统计学意义(P＞0.05)。与听力正常组相比，听力下降组患者年龄较大(62.79 ± 10.60)岁 vs (47.53 ± 10.17)岁，P＜0.001、病程较长(11.36年 vs 6.77年，P＜0.001)、收缩压较高(133.85 ± 22.12 mmHg vs 126.21 ± 16.19 mmHg，P=0.006)、肌酐/尿微量白蛋白较高(215.05 mg·gCr-1 vs 41.90 mg·gCr-1，P=0.013)，血糖变异系数(coefficient of variation，CV)较高(30.20% vs 27.97%，P=0.034)、平均血糖(mean blood glucose，MBG)较高(9.49 ± 2.03 mmol·L-1 vs 8.73 ± 1.72 mmol·L-1，P=0.012)、平均血糖标准差较高(standard deviation of mean blood glucose，SDBG)(2.90 ± 1.01 mmol·L-1 vs 2.48 ± 0.96 mmol·L-1，P=0.007)，而肾小球滤过率较低(82.19 mL·min-1·1.73 m2-1 vs 100.15 mL·min-1·1.73 m2-1，P＜0.001)。有序多分类logistic回归分析显示糖尿病病程(OR=1.047，95% CI：1.015 ~ 1.080)、SDBG(OR=1.337，95% CI：1.002 ~ 1.783)、高血压(OR=1.721，95% CI：1.017 ~ 2.913)、冠心病(OR=1.970，95% CI：1.019 ~ 3.806)为不同严重程度下糖尿病听力下降的危险因素。
    结论 45 ~ 59岁(中年)糖尿病患者听力下降风险更高，且糖尿病病程＜3年时听力下降的风险已较高，以高频听力下降和轻度听力下降为主，利用电测听结合DPOAE可更早期更准确的发现糖尿病听力下降。

     

    Abstract:
    Background Hearing loss is one of the complications of diabetes, but it is less recognized than other complications. And the guidelines do not mention hearing loss in diabetes.
    Objective To explore the association between diabetes and hearing loss.
    Methods Totally 222 patients with diabetes mellitus admitted to the Department of Endocrinology and Metabolism, General Hospital of Guangzhou Military Command of PLA, from September 2022 to March 2023 were collected and divided into normal hearing group and hearing loss group according to whether they had diabetes mellitus hearing loss. Ordinal multinomial Logistic regression analysis was used to evaluate the related risk factors for the severity of hearing loss in diabetic patients.
    Results A total of 222 diabetic patients were enrolled, including 165 patients in the hearing loss group and 57 patients in the normal hearing group. There were 95 males (57.6%) in the hearing loss group and 38 males (66.7%) in the normal hearing group. There was no significant difference between the two groups (P > 0.05). Compared with the normal hearing group, patients with hearing loss were older (62.79 ± 10.60 years vs 47.53 ± 10.17 years, P＜0.001), had longer disease duration (11.36 years vs 6.77 years, P < 0.001) and higher systolic blood pressure (133.85 ± 22.12 mmHg vs 126.21 ± 16.19 mmHg, P=0.006), higher creatinine/urinary microalbumin ratio (215.05 mg·gCr-1 vs 41.90 mg·gCr-1, P = 0.013). The coefficient of variation of blood glucose (30.20% vs 27.97%, P=0.034), the mean blood glucose (9.49 ± 2.03 mmol·L-1 vs 8.73 ± 1.72mmol·L-1, P=0.012), and the standard deviation of mean blood glucose were also higher (2.90 ± 1.01 mmol·L-1 vs 2.48 ± 0.96 mmol·L-1, P=0.007). However, the estimated glomerular filtration rate was lower (82.19 mL·min-1·1.73m2-1 vs 100.15 mL·min-1·1.73m2-1, P＜0.001). There were significant differences in diabetic retinopathy, diabetic kidney disease, hypertension and coronary heart disease between the two groups (all P < 0.05). Ordinal multinomial logistic regression analysis showed that the course of disease (OR=1.047, 95% CI: 1.015 ~ 1.080), SDBG (OR=1.337, 95% CI: 1.002 ~ 1.783), hypertension (OR=1.721, 95% CI: 1.017 ~ 2.913) and coronary atherosclerotic cardiopathy (OR=1.970, 95% CI: 1.019 ~ 3.806) were risk factors for hearing loss in patients with different severity of diabetes.
    Conclusion  The risk of hearing loss is higher in middle-aged (45-59 years old) diabetic patients, and the risk of hearing loss is higher when the duration of diabetes is less than 3 years, mainly presents as high-frequency hearing loss and mild hearing loss. The use of electrical audiometry combined with DPOAE can detect diabetic hearing loss earlier and more accurately.

     

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