Tomisawa H
Department of Otolaryngology, St. Marianna University School of Medicine, Kanagawa.
Nihon Jibiinkoka Gakkai Kaiho. 2000 Nov;103(11):1227-37. doi: 10.3950/jibiinkoka.103.1227.
Sensorineural hearing loss can be caused by diabetes mellitus, and diabetic microangiopathy contributes to diabetic complications such as nephropathy. I compared the outer diameter of strial capillaries, the strial atrophy rate, and basement membrane thickening in the strial capillaries of temporal bone sections from 16 diabetics and 16 non-diabetics matched for age and sex and assessed the correlations between these values and age, duration of disease, fasting blood sugar, and glycohemoglobin. In the non-diabetic group, the minimum and maximum outer diameters of the capillary in the cochlear apical turn were larger than in the basal and middle turns. The strial atrophy rate in the apical turn was higher than in the basal and middle turns. There was no significant difference in basement membrane width between the turns. In the diabetic group, there were no significant differences in minimum outer diameter and basement membrane width between the turns. The maximum outer diameter of the middle turn was larger than that of basal turn. The strial atrophy rate in the apical turn was higher than in the basal and middle turn. In the comparison between the diabetic group and the non-diabetic group, the maximum outer diameter of the apical turn in the diabetics was smaller than in the non-diabetics, the basement membrane width in the basal, apical and all three turns as a whole in the diabetics was thicker than in the non-diabetics, the strial atrophy rate in the basal turn and all three turns as a whole in diabetics was higher than in non-diabetics. There were two correlations in the non-diabetics, between age and strial atrophy rate and between age and basement membrane width in the basal turn, and there were positive correlations in the diabetics, between the strial atrophy rate and fasting blood sugar and between strial atrophy rate and glycohemoglobin in the basal turn. Because of basement membrane thickening toward capillary lumen, these results led to the hypothesis that strial atrophy is one factor in diabetic hearing loss.
感音神经性听力损失可由糖尿病引起,糖尿病微血管病变会导致糖尿病并发症,如肾病。我比较了16名糖尿病患者和16名年龄及性别相匹配的非糖尿病患者颞骨切片中血管纹毛细血管的外径、血管纹萎缩率以及血管纹毛细血管基底膜增厚情况,并评估了这些值与年龄、病程、空腹血糖和糖化血红蛋白之间的相关性。在非糖尿病组中,耳蜗顶转毛细血管的最小和最大外径大于基底转和中转。顶转的血管纹萎缩率高于基底转和中转。各转之间基底膜宽度无显著差异。在糖尿病组中,各转之间的最小外径和基底膜宽度无显著差异。中转的最大外径大于基底转。顶转的血管纹萎缩率高于基底转和中转。在糖尿病组和非糖尿病组的比较中,糖尿病患者顶转的最大外径小于非糖尿病患者,糖尿病患者基底转、顶转以及整个三转的基底膜宽度均比非糖尿病患者厚,糖尿病患者基底转和整个三转的血管纹萎缩率高于非糖尿病患者。在非糖尿病患者中存在两种相关性,即年龄与血管纹萎缩率之间以及年龄与基底转基底膜宽度之间;在糖尿病患者中存在正相关性,即基底转的血管纹萎缩率与空腹血糖之间以及血管纹萎缩率与糖化血红蛋白之间。由于基底膜向毛细血管腔增厚,这些结果导致了血管纹萎缩是糖尿病性听力损失的一个因素这一假设。