Characteristics Of Vestibular Evoked Myogenic Potentials In Patients With Type 2 Diabetes Mellitus

Objective:Vestibular evoked myogenic potential is a short-latency myogenic response recorded on the surface of tense muscle skin by a certain frequency of air-conducted sound,bone-conducted vibration or current stimulation through the vestibular nerve to the central nerve conduction pathway.VEMP was initially used to evaluate otolith function,and later studies have found that it can also be used to evaluate the function of peripheral vestibular nerve reflex and even central vestibular nerve pathway.Chronically increased blood glucose levels may affect the vestibular system by damaging cells and nerve structures in type 2 diabetes mellitus,followed by dizziness,unstable walking,falls and other symptoms,thus affecting the daily life of the patients.We examined the vestibular evoked myogenic potentials to explore the characteristics of vestibular neuropathy in patients with type 2 diabetes mellitus.Methods:34 patients(68 ears)with type 2 diabetes mellitus with peripheral neuropathy(DNP group),55 patients with type 2 diabetes without peripheral neuropathy(DM group)and42 healthy controls(84 ears)were examined by AC ocular vestibular evoked myogenic potential(oVEMP)and cervical vestibular evoked myogenic potential(cVEMP)in the endocrinology department of our hospital from December 2019 to December 2020.The latency,amplitude and binaural asymmetry ratio(AR)of oVEMP and cVEMP were compared among the three groups,and the correlation betweenVEMP and the course of disease,fasting blood glucose,Hb A1 c,uric acid,blood lipids(TG,TC,HDL-C,LDL-C)and obese(BMI)were calculated.Results:There was no significant difference in the latency and amplitude of oVEMP and cVEMP between the left ear and the right ear in the healthy control group.Compared with the healthy control group,oVEMP n10 and p15 latencies in DNP group were prolonged,and compared with the DM group,oVEMP n10 and p15 latencies in DNP group were prolonged,the difference is statistically significant.(P < 0.01).There was no significant difference in oVEMP amplitude and AR among groups.Compared with the control group,the amplitude of cVEMP in DM group and DNP group decreased,and that in DNP group decreased more than that in normal group(P < 0.01).There was no significant difference in cVEMP latency and AR among groups.The n10 latencies of oVEMP was positively correlated with the course of disease,and the difference was statistically significant(r=0.169,p=0.025),that is,the latency was prolonged with the increase of the course of disease.The amplitude of oVEMP was negatively correlated with the course of disease,and the difference was statistically significant(r=-0.179,p=0.017),that is,the amplitude decreased with the increase of the course of disease.There was a positive correlation between oVEMP latency p15 and glycosylated hemoglobin,and the difference was statistically significant(r=0.134,p=0.03),that is,the latency was prolonged with the increase of glycosylated hemoglobin.Conclusion:Vestibular evoked myogenic potential(oVEMP and cVEMP)indicates that there are subclinical vestibular neuropathy in patients with type 2 diabetes mellitus,and peripheral and central nerve damage may occur with the prolongation of the course of disease.Vestibular evoked myogenic potentials can be used to evaluate vestibular neuropathy in patients with diabetes.