Department of Biostatistics & Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK.
Biomed Res Int. 2018 Jul 9;2018:2714590. doi: 10.1155/2018/2714590. eCollection 2018.
The current study was aiming to investigate the relation between vitamin D, retinopathy, and hearing loss among type 2 diabetes mellitus (T2DM) patients.
Cross-sectional study carried on 638 subjects aged between 20 and 60 years who visited the Endocrinology, Ophthalmology, and ENT Outpatient Clinics of the Medipol Hospital during the period from March 2016 to May 2017. Two audiometers Grason Stadler GSI 61 and Interacoustics AC40 Clinical audiometer were used to evaluate the hearing loss. Risk factors for diabetic retinopathy were evaluated, including age, sex, diabetes duration, glycated hemoglobin (HbA1c), hypertension, and lipid profiles.
The mean age (± SD, in years) for retinopathy with hearing loss versus normal subjects was 47.7 ±10.2 versus 48.5±9.1. The associated risk factors were significantly higher in T2DM with hearing loss, hypertension (32.6% versus 15.7%), tinnitus (40.0% versus 18.0%), vertigo (59.7% versus 26.8%), and headache (54.9% versus 45.3%), than in normal hearing diabetes. There were statistically significant differences between hearing impairment versus normal hearing for vitamin D [19.40±9.71 ng/ml versus 22.67±9.28 ng/ml; p<0.001], calcium, magnesium, phosphorous, cholesterol, HDL-C, LDL-C, albumin, systolic blood pressure [131.70±9.25 Hg versus 127.73±11.98 Hg], diastolic blood pressure [82.20±8.60 mm Hg versus 79.80±8.20 mm Hg], and microalbuminuria. Multivariate logistic regression analysis revealed that variables such as vertigo, duration of DM, mobile/I pad phone, vitamin D deficiency, sleeping disturbance, headache, frequently TV watching, tinnitus, cigarette smokers, and hypertension were considered at higher risk as a predictors of retinopathy with hearing loss among diabetic patients.
Vitamin D deficiency is considered as a risk factor for diabetic retinopathy and hearing loss among diabetic patients. Meanwhile, hyperglycemia could be considered as a modifiable risk factor for diabetic retinopathy; tight glycemic control may be the most effective and important therapy for improving quality of life and substantially reducing the incidence of retinopathy and in T2DM patients.
本研究旨在探讨 2 型糖尿病（T2DM）患者的维生素 D、视网膜病变和听力损失之间的关系。
这是一项横断面研究，纳入了 2016 年 3 月至 2017 年 5 月期间在 Medipol 医院内分泌科、眼科和耳鼻喉科门诊就诊的年龄在 20 至 60 岁之间的 638 例患者。使用 Grason Stadler GSI 61 和 Interacoustics AC40 临床听力计评估听力损失。评估了糖尿病视网膜病变的危险因素，包括年龄、性别、糖尿病病程、糖化血红蛋白（HbA1c）、高血压和血脂谱。
与正常组相比，伴有听力损失的视网膜病变患者的平均年龄（±SD，岁）为 47.7±10.2 岁 vs. 48.5±9.1 岁。T2DM 伴有听力损失的患者的相关危险因素显著更高，包括高血压（32.6% vs. 15.7%）、耳鸣（40.0% vs. 18.0%）、眩晕（59.7% vs. 26.8%）和头痛（54.9% vs. 45.3%）。与正常听力的糖尿病患者相比，维生素 D[19.40±9.71ng/ml vs. 22.67±9.28ng/ml；p<0.001]、钙、镁、磷、胆固醇、HDL-C、LDL-C、白蛋白、收缩压[131.70±9.25Hg vs. 127.73±11.98Hg]、舒张压[82.20±8.60mm Hg vs. 79.80±8.20mm Hg]和微量白蛋白尿有统计学差异。多变量逻辑回归分析显示，眩晕、糖尿病病程、手机/Ipad 电话、维生素 D 缺乏、睡眠障碍、头痛、频繁看电视、耳鸣、吸烟者和高血压等变量被认为是糖尿病患者伴听力损失的视网膜病变的更高风险预测因素。
维生素 D 缺乏被认为是糖尿病患者伴听力损失和视网膜病变的危险因素。同时，高血糖可能被认为是糖尿病视网膜病变的可改变危险因素；严格的血糖控制可能是改善生活质量和显著降低 T2DM 患者视网膜病变发生率的最有效和最重要的治疗方法。
