Arduc Ayse, Isık Serhat, Allusoglu Serpil, Iriz Ayse, Dogan Bercem Aycicek, Gocer Celil, Tuna Mazhar Muslim, Berker Dilek, Guler Serdar
National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes, Endocrine and Obesity Branch, National Institutes of Health, Bethesda, MD, USA.
, 1778 Dawson Street, Vienna, VA, 22182, USA.
Endocrine. 2015 Dec;50(3):708-14. doi: 10.1007/s12020-015-0624-8. Epub 2015 May 12.
Sensorineural hearing loss has been reported in various autoimmune diseases. The relationship between Hashimoto's thyroiditis (HT) and the auditory system has not been previously evaluated. In this study, we investigated the effect of euthyroid HT on the hearing ability of adult patients. The study included 30 patients with newly diagnosed euthyroid HT and 30 age- and gender-matched healthy controls. All subjects had a normal otoscopic examination and tympanometry, and they were negative for rheumatoid factor, antinuclear, anti-smooth muscle, antimitochondrial, antineutrophilcytoplasmic, and antigliadin antibodies. Pure tone audiometry exams at 250, 500, 1000, 2000, 4000, 6000, and 8000 Hertz (Hz) were performed in both groups. Thyroid peroxidase antibody and thyroglobulin antibody (anti-Tg) levels were higher in HT group while TSH, free T4, free T3, plasma electrolytes, glucose, lipid profile, vitamin B12, and blood pressure measurements were similar between the two groups. Higher audiometric thresholds and a higher prevalence of hearing loss at 250, 500, and 6000 Hz were detected in the HT patients than in the healthy controls (P < 0.05). Hearing levels at 250 and 500 Hz correlated positively with anti-Tg levels (ρ = 0.650, P = 0.002; ρ = 0.719, P < 0.001, respectively), and this association remained significant in linear regression analysis. Anti-Tg-positive HT patients had higher hearing thresholds at 250 and 500 Hz than anti-Tg-negative HT patients. Hearing thresholds were similar between anti-Tg-negative HT patients and the control subjects. This study demonstrated that hearing functions are impaired in HT patients. Thyroid autoimmunity seems to have an important impact on a decreased hearing ability, particularly at lower frequencies, in this population of patients.
已有报道称各种自身免疫性疾病中存在感音神经性听力损失。此前尚未评估桥本甲状腺炎(HT)与听觉系统之间的关系。在本研究中,我们调查了甲状腺功能正常的HT对成年患者听力的影响。该研究纳入了30例新诊断的甲状腺功能正常的HT患者以及30例年龄和性别匹配的健康对照。所有受试者的耳镜检查和鼓室图均正常,类风湿因子、抗核抗体、抗平滑肌抗体、抗线粒体抗体、抗中性粒细胞胞浆抗体和抗麦醇溶蛋白抗体均为阴性。两组均进行了250、500、1000、2000、4000、6000和8000赫兹(Hz)的纯音听力测试。HT组的甲状腺过氧化物酶抗体和甲状腺球蛋白抗体(抗Tg)水平较高,而两组之间的促甲状腺激素、游离T4、游离T3、血浆电解质、葡萄糖、血脂、维生素B12和血压测量值相似。与健康对照相比,HT患者在250、500和6000 Hz处的听力阈值更高,听力损失患病率也更高(P < 0.05)。250和500 Hz处的听力水平与抗Tg水平呈正相关(ρ = 0.650,P = 0.002;ρ = 0.719,P < 0.001),并且这种关联在线性回归分析中仍然显著。抗Tg阳性的HT患者在250和500 Hz处的听力阈值高于抗Tg阴性的HT患者。抗Tg阴性的HT患者与对照受试者的听力阈值相似。本研究表明HT患者的听力功能受损。甲状腺自身免疫似乎对该患者群体的听力下降有重要影响,尤其是在低频时。