Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
Renal Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Diabetologia. 2019 Feb;62(2):281-285. doi: 10.1007/s00125-018-4766-0. Epub 2018 Nov 6.
AIMS/HYPOTHESIS: Type 2 diabetes mellitus has been implicated as a risk factor for hearing loss, with possible mechanisms including microvascular disease, acoustic neuropathy or oxidative stress. A few small studies have examined the longitudinal association between type 2 diabetes and hearing loss, but larger studies are needed. Our objective was to examine whether type 2 diabetes (including diabetes duration) is associated with incident hearing loss in two prospective cohorts: Nurses' Health Studies (NHS) I and II.
We conducted a longitudinal study of 139,909 women to examine the relationship between type 2 diabetes and the risk of self-reported incident hearing loss. A physician-diagnosis of diabetes was ascertained from biennial questionnaires. The primary outcome was hearing loss reported as moderate or worse in severity (categorised as a 'moderate or severe' hearing problem, or 'moderate hearing trouble or deaf') on questionnaires administered in 2012 in NHS I and 2009 or 2013 in NHS II. Cox proportional hazards regression was used to adjust for potential confounders.
During >2.4 million person-years of follow-up, 664 cases of moderate or worse hearing loss were reported among those with type 2 diabetes and 10,022 cases among those without type 2 diabetes. Compared with women who did not have type 2 diabetes, those with type 2 diabetes were at higher risk for incident moderate or worse hearing loss (pooled multivariable-adjusted HR 1.16 [95% CI 1.07, 1.27]). Participants who had type 2 diabetes for ≥8 years had a higher risk of moderate or worse hearing loss compared with those without type 2 diabetes (pooled multivariable-adjusted HR 1.24 [95% CI 1.10, 1.40]).
CONCLUSIONS/INTERPRETATION: In this large longitudinal study, type 2 diabetes was associated with a modestly higher risk of moderate or worse hearing loss. Furthermore, longer duration diabetes was associated with a higher risk of moderate or worse hearing loss.
目的/假设:2 型糖尿病已被认为是听力损失的一个风险因素,其可能的机制包括微血管疾病、听神经病或氧化应激。一些小型研究已经检查了 2 型糖尿病和听力损失之间的纵向关联,但需要更大规模的研究。我们的目的是在两个前瞻性队列研究中检查 2 型糖尿病(包括糖尿病病程)是否与听力损失的发生有关:护士健康研究(NHS)I 和 II。
我们对 139909 名女性进行了一项纵向研究,以研究 2 型糖尿病与自我报告的听力损失风险之间的关系。糖尿病的诊断是通过每两年一次的问卷确定的。主要结局是在 NHS I 的 2012 年和 NHS II 的 2009 年或 2013 年的问卷中报告的中度或更严重的听力损失(分为“中度或严重”听力问题或“中度听力障碍或耳聋”)。使用 Cox 比例风险回归来调整潜在的混杂因素。
在超过 240 万个人年的随访期间,在患有 2 型糖尿病的患者中报告了 664 例中度或更严重的听力损失,在没有 2 型糖尿病的患者中报告了 10022 例。与没有 2 型糖尿病的女性相比,患有 2 型糖尿病的女性发生中度或更严重听力损失的风险更高(汇总多变量调整后的 HR 1.16[95%CI 1.07, 1.27])。与没有 2 型糖尿病的患者相比,病程≥8 年的 2 型糖尿病患者发生中度或更严重听力损失的风险更高(汇总多变量调整后的 HR 1.24[95%CI 1.10, 1.40])。
结论/解释:在这项大型纵向研究中,2 型糖尿病与中度或更严重听力损失的风险略有增加有关。此外,病程较长与中度或更严重听力损失的风险增加有关。