Jáuregui-Renaud K, Aranda-Moreno C, Herrera-Rangel A
Unidad de Investigación Médica en Otoneurología.
Hospital General Regional no.72, Instituto Mexicano del Seguro Social, México.
Acta Otorhinolaryngol Ital. 2017 Oct;37(5):430-435. doi: 10.14639/0392-100X-1243.
The aim of this study was to assess the function of the utricle and horizontal semicircular canals in patients with type 2 diabetes mellitus receiving primary health care, with/without a history of falls. 101 patients with type 2 diabetes mellitus, 34 to 84 years old (26 with and 75 without a history of falls) and 51 healthy volunteers (40-83 years old) accepted to participate. They denied having a history of dizziness, vertigo, unsteadiness, hearing loss, or neurological disorders. None of them were seeking care due to sensory or balance decline. After a clinical evaluation and report of symptoms related to balance using a standardised questionnaire, lateral canal function was assessed by sinusoidal rotation at 0.16 Hz and 1.28 Hz (60°/sec peak velocity), otolith function was assessed by static visual vertical (average of 10 trials) and dynamic visual vertical during unilateral centrifugation (300°/sec at 3.5 cm) and static posturography was performed on hard/ soft surface with eyes open/closed. Compared to healthy volunteers, patients showed decreased responses to unilateral centrifugation, but similar responses to horizontal canal stimuli (independently of age, peripheral neuropathy or a history of falls) (ANCoVA p < 0.05) and a larger sway area with a lengthier sway path. Compared to patients with no falls, patients with falls had a higher female/male ratio and a higher frequency of score ≥ 4 on the questionnaire of symptoms related to balance, but similar age, body mass index and frequency of peripheral neuropathy. In patients with type 2 diabetes mellitus, receiving primary healthcare who are not seeking care due to sensory or balance decline, utricular function may be impaired even in the absence of horizontal canal dysfunction or a history of falls.
本研究旨在评估接受初级卫生保健的2型糖尿病患者（有/无跌倒史）的椭圆囊和水平半规管功能。101例2型糖尿病患者，年龄34至84岁（26例有跌倒史，75例无跌倒史），以及51名健康志愿者（40 - 83岁）同意参与。他们否认有头晕、眩晕、不稳、听力丧失或神经疾病史。他们均未因感觉或平衡下降而寻求治疗。在进行临床评估并使用标准化问卷报告与平衡相关的症状后，通过0.16 Hz和1.28 Hz（峰值速度60°/秒）的正弦旋转评估外侧半规管功能，通过静态视觉垂直（10次试验的平均值）和单侧离心过程中的动态视觉垂直（3.5 cm处300°/秒）评估耳石功能，并在硬/软表面睁眼/闭眼状态下进行静态姿势描记。与健康志愿者相比，患者对单侧离心的反应降低，但对水平半规管刺激的反应相似（与年龄、周围神经病变或跌倒史无关）（协方差分析p < 0.05），且摆动面积更大，摆动路径更长。与无跌倒史的患者相比，有跌倒史的患者女性/男性比例更高，在与平衡相关症状的问卷上得分≥4的频率更高，但年龄、体重指数和周围神经病变频率相似。在接受初级卫生保健且未因感觉或平衡下降而寻求治疗的2型糖尿病患者中，即使没有水平半规管功能障碍或跌倒史，椭圆囊功能也可能受损。
