An Association Of Type ? Diabetes Mellitus With Auditory Dysfunction: A Systematic Review And Meta-Analysis

Objective:To establish the relationship between the presence of type I diabetes mellitus(DM)and auditory dysfunction in clinical settings by a systematic review and meta-analysis of currently available published data.Data Sources and Review Methods:The electronic databases PubMed,Embase,and Wanfang Data were searched for eligible relevant studies,and the reference lists of the retrieved articles were used for additional manual search.All the articles included in this pooled analysis were determined according to the preset inclusion and exclusion criteria.Methodological quality was assessed by the Newcastle-Ottawa Scale.Meta-analysis of pooled data was performed using Review Manager 5.3.Results:A total of 15 studies were included for further combined analysis.Of those,only four studies demonstrated the incidence of hearing loss in type ? diabetes and controls;five studies provided the mean values of the PTA thresholds for diabetes patients and control subjects at various frequencies;and eight studies showed the mean values of latency and interpeak latency time of waves ?,?,and ?,respectively,and the intervals between them for both diabetic and control subjects.The results showed that patients with type 1 diabetes had a significantly higher prevalence of hearing loss than controls(OR = 49.08,95%CI = 12.03-200.31,P<0.00001);standardized mean of differences of pure tone audiometry at 4,000 Hz between diabetes and controls was0.87(Z = 2.22,P = 0.03,95%Cl = 0.10-1.64,I2 = 95%);standardized mean of differences of the latency time was0.54(Z = 2.69,P = 0.007,95%CI=0.15-0.93,I2=78%)for waves ? and 0.75(Z = 2.88,P = 0.004,95%CI?0.24-1.27,I2 = 86%)for wave V,respectively;and SMD of the interpeak latency time was0.41(Z = 2.84,P = 0.005,95%CI =0.13-0.70,I2=39%)for waves ? to ?and0.72(Z = 3.30,P = 0.001,95%CI = 0.29-1.14?I2=76%)for waves ? to ?,respectively,between diabetics and controls.Conclusion:Our study reveals that there is relationship between the presence of type I DM and an increased risk for developing mild and subclinical high frequency hearing impairment and dysfunctions of the central auditory pathway.