The Relationship Between Type 2 Diabetic Peripheral Neuropathy And Hearing Impairment

Objective:This paper is based on pure tone audiometry(PTA),distortion product otoacoustic emission(DPOAE)to inspect the auditory function of the patients with diabetic peripheral neuropathy(DPN),explore the relationship between DPN and hearing impairment,and analyze the factors related to hearing impairment.Early screening and intervention of diabetic patients with hearing impairment and provide the basis.Methods:1.Selecting 70 patients of type 2 diabetes hospitalized in the Department of Endocrinology and metabolism from the Second Affiliated Hospital of Nanchang University From February 2016 to January 2017 as the experimental group,the experimental group were divided into DPN group of 35 cases and non DPN group of 35 cases;The other 34 cases from health examination in the same hospital were selected as healthy control group.2.Nerve conduction velocity(NCV),PTA and DPOAE examinations were performed in 104 subjects.Compared with three groups of general datas,clinical datas,serological datas;Compared with three groups of PTA results,DPOAE amplitudes results;Compared with DPOAE amplitudes results of subjects whose PTA were normal results;To analyze the severity of diabetic neuropathy and the severity of hearing loss.To analyze the risk factors of hearing loss in type 2 diabetes mellitus.Result:1.DPN group,non-DPN group in glycosylated hemoglobin(HbA1c),fasting plasma glucose(FBG),postprandial blood glucose(PBG),cholesterol(TC),glycerol three fat(TG),low density lipoprotein(LDL-C),urinary microalbumin compared with the healthy control group were significantly different,(all P <0.05),but there was no difference between the DPN group and the non-DPN group(P>0.05)2.PTA results showed that there were 19 cases with normal haring,10 cases with mild loss,5 cases with moderate loss,1 case with severe loss,0 case with extremely severer loss in DPN group;27 cases with normal hearing,8 cases with mild loss,0 case with moderate loss,0 case with severe loss,0 case with extremely severer loss in non-DPN group;34 cases with normal hearing in control group.On all frequency ponts of 0.5 KHz?1.0 KHz?2.0 KHz?4.0KHz,The hearing thresholds of DPN group were higher than that in non-DPN group and healthy control group(all P <0.05).Only on the frequency points of 0.5 KHz and 4.0KHz,the hearing thresholds of DPN group were higher than that in healthy control group(P<0.05).3.DPOAE amplitudes results showed that,on all frequency points of 0.5 KHz?1.0 KHz?2.0 KHz?4.0 KHz?8.0KHz,DPOAE amplitudes of DPN group were lower than that in non-DPN group and healthy control group(all p<0.05),only on the frequency points of 4.0 KHz and 8.0KHz,DPOAE amplitudes of non-DPN group were lower than that in healthy control group(p<0.05).4.DPOAE amplitudes results of subjects whose PTA were normal showed that,on the frequency points of 0.5 KHz?1.0 KHz?2.0 KHz?4.0 KHz?8KHz,DPOAE amplitudes of the DPN were lower group than in healthy control group(p<0.01),on the frequency points of 0.5 KHz?1.0 KHz?2.0 KHz?4.0 KHz,DPOAE amplitudes of the DPN group were lower than that in non-DPN group,only on the frequency points of 8.0KHz,DPOAE amplitudes of non-DPN group were lower than that in healthy control group(p<0.01).5.The Spearman correlation analysis showed that the severity of diabetic neuropathy was positively correlated with the severity of hearing loss.6.Multivariate binary logistic regression analysis showed that the duration of patients with T2 DM hospitalized(regression coefficient =0.09,p=0.013),glycosylated hemoglobin(regression coefficient =0.205,p=0.001)were independent risk factors of hearing impairment.Conclusions:1.Diabetic patients with hearing loss are mostly mild and moderate,more likely to suffer from impaired high-frequncy hearing;DPN are often more likely to suffer from hearing loss and impaired low-frequency,medium-frequency and high-frequency hearing.2.The longer duration and high blood glucose of diabetics may be more likely to be associated with hearing loss.Diabetic patients should actively control blood sugar,early diabetes should strengthen the monitoring of hearing,especially in patients with peripheral neuropathy.3.DPOAE can be used to evaluate early cochlear damage in normal hearing of patients with type 2 diabetes and peripheral neuropathy.