The Clinical Research Of Occult Hearing Impairment In Patients With Type 2 Diabetes Mellitus

Objective: To analyze the characteristics of occult hearing impairment in patients with type 2 diabetes mellitus(T2DM),and to explore the clinical value of Distortion Product Otoacoustic Emission(DPOAE)in improving the early diagnosis level of T2 DM patients with occult hearing impairment.Moreover,the potential risk factors of occult hearing impairment of T2 DM patients were further analyzed,which could provide useful information for the prevention and early treatment.Methods: A total of 65 cases of T2 DM patients with no perceived hearing loss and having normal examination result in words frequency of Pure-one Audiometry,were collected as study group from June to December of 2017 in affiliated hospital of Zunyi medical college,and 18 healthy patients were enrolled as control group.Firstly,the high frequency of Pure-tone Audiometry and DPOAE were conducted to analyze the characteristics of occult hearing impairment in T2 DM patients.Then the early diagnostic value of DPOAE in T2 DM occult hearing impairment was further explored by using ROC curve.Moreover,variable potential factors for hearing impairment in T2 DM patients,such as blood glucose and blood lipid,were analyzed by multivariate Logistic regression.Results: Compared with the control group,the Pure-tone Threshold Average(PTA)of T2 DM patients is higher than that in the control group,and the difference between the two groups in the right ear was statistically significant(P<0.05).The high frequency auditory threshold(4kHZ,8kHZ)was significantly higher than that in the control group,and the threshold comparison between different frequencies for the study group of 8kHZ>4kHZ>PTA,and the difference is statistically significant(P <0.05).In the study group,the amplitude of DPOAE and the number of frequencies with positive result of DPOAE is significantly lower than that in the control group,and the difference is statistically significant(P<0.05).Among them,the amplitude differences of 1.5 kHZ,2 kHZ,3 KHZ is statistically significant(P<0.05),the amplitude differences of 1.5 kHZ,2 kHZ,3 kHZ and 4 kHZ,6 kHZ,8 KHZ in right ear is statistically significant(P<0.05).The sensitivity of DPOAE is 76.8%,and the specificity is 68.9%.Multivariate Logistic regression analysis showed that TC and left ear hearing loss in T2 DM patients is positively correlated,TC,FCP and the right ear hearing loss in T2 DM patients is positively correlated,and LDL-C,c-peptide 2h is negatively correlated with the hearing loss in the right ear.Conclusion: The characteristics of occult hearing impairment in patients with type 2 diabetes is that the words frequency hearing loss is not obvious,the high frequency hearing loss is obvious,at 8k HZ is most obvious.The sensitivity and specificity of DPOAE in the diagnosis of occult hearing impairment in T2 DM are high,which has certain advantages compared with the Pure-tone audiometry,it can detect the occult hearing impairment of T2 DM earlier.TC,C peptide and LDL-C are possible risk factors for hearing impairment in T2 DM patients.