Veterans Affairs Rehabilitation Research and Development Service, National Center for Rehabilitative Auditory Research, Portland Veterans Affairs Medical Center, Portland, Oregon 97239, USA.
Laryngoscope. 2010 Jan;120(1):150-8. doi: 10.1002/lary.20636.
OBJECTIVES/HYPOTHESIS: Determine effects on auditory brainstem response (ABR) of diabetes mellitus (DM) severity.
A cross-sectional study investigating DM severity and ABR in military Veteran subjects with (166) and without (138) DM and with no more than moderate hearing loss.
Subjects were classified by three age tertiles (<50, 50-56, and 57+). DM severity was classified as insulin-dependent (IDDM), non-insulin-dependent (NIDDM), or no DM. Other DM measures included serum glucose, HbA1c, and several DM-related complications. ABR measures included wave I, III, and V latencies; I-III, III-V, and I-V latency intervals; and wave V amplitude; for each ear at three repetition rates (11, 51, and 71 clicks/second), and both polarities. Outcomes were stratified by age tertile and adjusted for pure tone threshold at 3 kHz. Repeated measures multivariate analysis of covariance modeled the ABR response at each repetition rate for DM severity (main effect) and hearing at 3 kHz (covariate). Modeled contrasts between ABR variables in subjects with and without DM were examined.
Significant differences existed between no DM and IDDM groups in the younger tertile only. Adjusting for threshold at 3 kHz had minimal effect. Self-reported noise exposure was not related to ABR differences, but HbA1c and poor circulation were.
IDDM is associated with an increased wave V latency, wave I-V interval, and reduced wave V amplitude among Veterans under 50 years. Results were related to several DM complications.
目的/假设：确定糖尿病严重程度对听觉脑干反应（ABR）的影响。
一项横断面研究，调查了患有（166 例）和不患有（138 例）糖尿病且听力损失不超过中度的退伍军人受试者的糖尿病严重程度和 ABR。
受试者按三个年龄三分位数（<50、50-56 和 57+）进行分类。糖尿病严重程度分为胰岛素依赖型（IDDM）、非胰岛素依赖型（NIDDM）或无糖尿病。其他糖尿病指标包括血清葡萄糖、HbA1c 和几种糖尿病相关并发症。ABR 指标包括每只耳朵在三个重复率（11、51 和 71 次/秒）和两种极性下的 I、III 和 V 波潜伏期；I-III、III-V 和 I-V 潜伏期间隔；以及 V 波振幅。结果按年龄三分位数分层，并校正 3 kHz 的纯音阈值。重复测量多元协方差分析模型以每个重复率的 ABR 反应为 DM 严重程度（主效应）和 3 kHz 的听力（协变量）。在有无糖尿病的受试者中，对 ABR 变量进行了模型对照检验。
仅在年轻三分位数中，无糖尿病和 IDDM 组之间存在显著差异。校正 3 kHz 的阈值对结果的影响极小。自我报告的噪声暴露与 ABR 差异无关，但 HbA1c 和循环不良有关。
在 50 岁以下的退伍军人中，IDDM 与 V 波潜伏期增加、I-V 波间隔增加和 V 波振幅降低有关。结果与几种糖尿病并发症有关。
