The Evaluation And Analysis Of The Auditory Impairment And Its Related Risk Factors In Patients With Type 1 Diabetics

[Objective] This study aimed to evaluate auditory function of type 1 diabetic patients and the correlation between clinical indexes and hearing impairment.[Methods] The clinical indicators of gender, age, body mass index, blood pressure, triglyceride, cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, serum creatinine, blood urea nitrogen, glycosylated hemoglobin, microalbuminuria, fundus oculi and electromyogram were examination in the 50 type 1 diabetics and 50 healthy subjects.We evaluated the auditory function of type 1 diabetics and healthy subjects by pure-tone audiometry, auditory brainstem response and otoacoustic emissions. Clinical indexes were measured and their relation of auditory function also analyzed.[Results]1.As shown in Table 1, GHbA1C, serum Cr, and microalbuminuria of type 1 diabetic group were significantly higher than those of healthy controls. Peripheral neuropathy was identified in 3 patients (6%) using an electromyogram and ophthalmologic evaluation showed diabetic retinopathy in 3 patients (6%). Nine type 1 diabetic patients (18%) were diagnosed diabetic nephropathy with macroalbuminuria.2.The averages of pure-tone thresholds in both type 1 diabetics and controls were in the normal range. However, type 1 diabetics demonstrated a deficit with elevated thresholds at right ear (250,1000,2000,4000 Hz and 8000 Hz) and left ear (250,500, 1000,4000Hz and 8000 Hz) compared with those of healthy controls (P<0.01) (Figure 1). According to the results of pure-tone audiometry, relationship between HDL-cholesterol, duration of DM, systemic blood pressure (SBP) and elevated auditory threshold of type 1 diabetes had statistically significant(P<0.05, Table 2).3. Latencies of right ear (wave â…¢, â…¤ and interwave â… -â…£) and left ear (wave â…¢, â…¤ and interwave â… -â…¢, â… -â…¤) in diabetic group significantly increased compared to those in control subjects (P<0.01). The auditory pathways damage of type 1 diabetes was significant related to GHbA1C and microalbuminuria(P<0.01, Table 3).4.DPOAE of diabetes group were statistically significant in right ear at 4.0,6.0 kHz and left 4.0,6.0,8.0 kHz (P<0.01, Figure 3) than those of controls. Only TG revealed positively correlated to the hearing impairment defined by DPOAE (P<0.01, Table 4).5.There was no significance of TEOAE between two groups(P>0.05, Figure 4). The TEOAE results showed that hearing loss was associated with age and GHbA1C(P <0.01,Table 5).[Conclusions]1.In type 1 diabetic group, the form of hearing loss included higher auditory threshold, slower conduction time of auditory pathway and elevated motility of the OHCs.The hearing loss is characterized as bilateral, sensorineural and subclinical impairment in young type 1 diabetics.2. The level of clinical indicators such as HDL-cholesterol, duration of DM, SBP, GHbA1C and Alb, TG, age may affect the auditory function in type 1 diabetes group. 3.Pure tone audiometry, otoacoustic emission and auditory bainstem response can be used as cnventional test methods for early diagnosis of diabetic hearing loss.