Characteristics And Related Factors Of Hearing Impairment In Patients With Type 2 Diabetes Mellitus

Objective: Hearing impairment is a common but neglected complication of diabetes mellitus.There are few studies on its pathogenesis and risk factors.To evaluate the hearing function in patients with type 2 diabetes mellitus(T2DM)by pure tone audiometry(PTA)and brainstem auditory evoked potential(BAEP)in order to analyze the characteristics and related factors of hearing impairment in patients with type 2 diabetes mellitus.Methods: 1.140 patients with type 2 diabetes who were treated in Sichuan People's Hospital from July 2017 to December 2018 and 54 healthy controls were collected.All subjects were tested for pure tone audiometry(PTA)and brainstem auditory evoked potential(BAEP),and the characteristics of hearing changes in type 2 diabetes were analyzed.2.Type 2 diabetes mellitus patients were divided into diabetic group with hearing impairment(group A)and diabetic group without hearing impairment(group B)according to the results of pure tone audiometry.At the same time,the data of possible influencing factors of hearing impairment in diabetic patients were collected,including basic data of patients,general diabetic examination and related complications,such as age,sex,course of diabetes,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),glycolated Hemoglobin A1c(HbA1c),fasting blood glucose(FBG),neutrophil-lymphocyte ratio(NLR),blood urea nitrogen(BUN),serum creatinine(Cr),estimated Glomerular Filtration Rate(eGFR),triglyceride(TG),total Cholesterol(TC),low density lipoprotein-Cholesterol(LDL-C),high density lipoprotein-cholesterol(HDL-C),uric acid(UA),2-hour C-peptide increment(?CP),urinary albumin-to-creatinine ratio(UACR),nerveconduction velocity(NCV)and fundus examination results were analyzed by multiple regression analysis to explore the possible influencing factors ofhearing impairment in type 2 diabetes mellitus.Results: 1.Compared with the control group,the hearing thresholds of diabetic patients were significantly higher at 1000 Hz,2000 Hz,4000 Hz and 8000 Hz,suggesting that the hearing impairment of diabetic patients was mainly in the middle and high frequencies;the peak latency(PL)of wave I,II,III,IV,V and the peak interval(IPL)of wave I-III,III-V and I-V in the diabetic group were longer than those in the control group(P < 0.05),indicating that type 2 diabetes mellitus had lesions in the whole brainstem auditory pathway.3.There were no significant differences in BUN,Cr,eGFR and HDL-C between diabetes with hearing impairment group(group A),diabetes without hearing impairment group(group B)and control group(group C)(P > 0.05).BMI,SBP,DBP,FBG,NLR,HbA1 c,FBG,TC,TG,LDL-C,UA were all significantly different between group A and group B(P < 0.05).Compared with group B,there were significant differences in course of disease,HbA1 c,UACR,NCV and retinopathy in group A(P <0.05).4.The unconditional logistic stepwise regression analysis was conducted with the presence of hearing abnormalities in diabetic patients as dependent variables(defined by PTA and BAEP results)and the possible related factors as independent variables,such as age,course of disease,HbA1 c,etc.The results showed when hearing abnormity(defined as PTA results)was taken as the dependent variable,age(OR 2.165,95% CI 1.569-3.562),course of disease(OR 1.926,95% CI 1.765-3.215),retinopathy(OR 1.163,95% CI 0.856-1.666)were risk factors for hearing impairment in type 2 diabetes mellitus,when hearing abnormity(defined as BAEP results)was taken as the dependent variable,age(OR 2.652,95% CI 1.845-8.362),course of disease(OR 2.012,95% CI 1.965-6.568),NCV(OR 1.965,95%CI 0.751-6.952)and UACR(OR1.022,95%CI 0.864~1.132)were risk factors for hearing impairment in type 2diabetes mellitus.Conclusion: Type 2 diabetes mellitus has middle and high frequency hearing impairment and abnormal brainstem auditory evoked potential.Age,course of disease and microvascular diseases are risk factors forhearing impairment in patients with type 2 diabetes mellitus.