Mujica-Mota Mario A, Patel Neel, Saliba Issam
Family Medicine Unit - Maisonneuve-Rosemont Hospital, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montreal, Montréal, QC, Canada.
Division of Otolaryngology-Head and Neck Surgery, University Hospital Center (CHUM), Montreal, QC, Canada.
Int J Pediatr Otorhinolaryngol. 2018 Oct;113:38-45. doi: 10.1016/j.ijporl.2018.07.005. Epub 2018 Jul 10.
Evidence shows type 1 diabetes(T1D) leads to vascular damage and neuropathy. The purpose of this study was to perform a systematic review and a meta-analysis to assess the evidence of the effects of T1D on hearing function.
Three electronic databases were used. The articles were independently reviewed by two authors using predefined inclusion criteria to identify eligible studies. They were then classified as high or low methodological quality. Meta-analysis was performed on pooled data of hearing loss(HL) prevalence, pure tone audiometry(PTA), otoacoustic emissions(OAE) and auditory brainstem response(ABR).
Twenty-one articles fulfilled the inclusion criteria. In all studies, HL was defined as pure tone greater than 20 dB in at least one frequency. The prevalence of HL ranged between 5.17% and 48% for diabetics, which was higher than in controls which ranged between 0% à 40% (OR = 7.7, 95% CI 3.32-17.98, p < 0.05 and I = 40%). The tendency of mean thresholds of PTA was higher in diabetics than in controls, with results being statistically significant at 250, 500 and 1000 Hz. OAE were significantly lower in diabetic patients. ABR latencies were longer in T1D group compared to controls and were statistical significant.
Patients with T1D have a significantly greater prevalence of HL compared to the control group. These damages could be compared to other microvascular diseases. Further studies are needed to assess whether hearing testing should be considered as a part of the screening process in T1D patients and therefore, secondary preventive treatment may be warranted as well.
有证据表明1型糖尿病（T1D）会导致血管损伤和神经病变。本研究的目的是进行系统评价和荟萃分析，以评估T1D对听力功能影响的证据。
使用了三个电子数据库。两位作者根据预先确定的纳入标准独立审查文章，以确定符合条件的研究。然后将它们分为方法学质量高或低两类。对听力损失（HL）患病率、纯音听力测定（PTA）、耳声发射（OAE）和听觉脑干反应（ABR）的汇总数据进行荟萃分析。
21篇文章符合纳入标准。在所有研究中，HL被定义为至少一个频率的纯音大于20 dB。糖尿病患者的HL患病率在5.17%至48%之间，高于对照组，对照组的患病率在0%至40%之间（OR = 7.7，95% CI 3.32 - 17.98，p < 0.05，I = 40%）。糖尿病患者的PTA平均阈值趋势高于对照组，在250、500和1000 Hz时结果具有统计学意义。糖尿病患者的OAE明显较低。与对照组相比，T1D组的ABR潜伏期更长，且具有统计学意义。
与对照组相比，T1D患者的HL患病率明显更高。这些损害可与其他微血管疾病相比较。需要进一步研究以评估听力测试是否应被视为T1D患者筛查过程的一部分，因此，二级预防性治疗也可能是必要的。
