Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.
Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.
Int J Environ Res Public Health. 2020 Jan 29;17(3):834. doi: 10.3390/ijerph17030834.
: Little evidence is available about the risk of sudden sensorineural hearing loss (SSNHL) in patients with thyroid diseases. We assessed whether a diagnosis of thyroid disease, particularly hyperthyroidism or hypothyroidism, is associated with SSNHL risk in an Asian population. This case-control study was conducted with population-based data from Taiwan's National Health Insurance Research Database from January 2000 to December 2013. The case group comprised 3331 adult patients with newly diagnosed SSNHL, and four controls without SSNHL for each case matched by sex, age, monthly income, and urbanization level of residence. Underlying Thyroid diseases were retrospectively evaluated in the case and control groups. Multivariate logistic regression analyses were used to explore relations between thyroid diseases and SSNHL. Of the 3331 cases, 5.7% had preexisting thyroid diseases, whereas only 4.0% of the 13,324 controls had the same condition. After adjustment for sex, age, monthly income, urbanization level of residence, history of hypertension, diabetes mellitus, chronic otitis media, and hyperlipidemia, associations were identified between a history of either hypothyroidism (adjusted odds ratio [AOR], 1.54; 95% CI, 1.02-2.32; = 0.042) or hyperthyroidism (AOR, 1.41; 95% CI, 1.07-1.85; = 0.015) and an elevated risk of SSNHL. In subgroup analysis, the correlation between hypothyroidism and increased SSNHL risk remained significant only for patients aged over 50 years (AOR, 1.61; 95% CI, 1.01-2.57; = 0.045), and that between hyperthyroidism and SSNHL was significant only for female patients (AOR, 1.48; 95% CI, 1.09-2.01; = 0.012). Treatment for hypothyroidism and hyperthyroidism did not alter the association in subgroup analyses. Preexisting hypothyroidism and hyperthyroidism appear associated with SSNHL susceptibility in Taiwan. Physicians should be wary of this elevated risk of SSNHL among patients with previously diagnosed thyroid dysfunction, especially women and patients aged more than 50 years.
在患有甲状腺疾病的患者中，突发性感觉神经性听力损失 (SSNHL) 的风险证据很少。我们评估了甲状腺疾病的诊断，特别是甲状腺功能亢进或甲状腺功能减退症，是否与亚洲人群中的 SSNHL 风险相关。这项病例对照研究使用了来自台湾国家健康保险研究数据库的基于人群的数据，时间范围为 2000 年 1 月至 2013 年 12 月。病例组包括 3331 名新诊断为 SSNHL 的成年患者，每个病例匹配四名无 SSNHL 的对照，匹配因素为性别、年龄、月收入和居住地的城市化水平。在病例组和对照组中回顾性评估了潜在的甲状腺疾病。使用多变量逻辑回归分析探讨了甲状腺疾病与 SSNHL 之间的关系。在 3331 例病例中，5.7%的患者存在先前的甲状腺疾病，而在 13324 名对照中，仅有 4.0%的患者存在相同的疾病。在校正性别、年龄、月收入、居住地城市化水平、高血压史、糖尿病史、慢性中耳炎和高血脂后，发现甲状腺功能减退症（调整后的优势比 [AOR]，1.54；95%置信区间 [CI]，1.02-2.32； = 0.042）或甲状腺功能亢进症（AOR，1.41；95%CI，1.07-1.85； = 0.015）与 SSNHL 风险升高之间存在关联。在亚组分析中，只有年龄超过 50 岁的患者中，甲状腺功能减退症与 SSNHL 风险增加之间的相关性仍然显著（AOR，1.61；95%CI，1.01-2.57； = 0.045），而女性患者中甲状腺功能亢进症与 SSNHL 之间的相关性显著（AOR，1.48；95%CI，1.09-2.01； = 0.012）。在亚组分析中，甲状腺功能减退症和甲状腺功能亢进症的治疗并未改变这种关联。在台湾，先前存在的甲状腺功能减退症和甲状腺功能亢进症似乎与 SSNHL 易感性相关。医生应警惕患有先前诊断为甲状腺功能障碍的患者中 SSNHL 的风险升高，尤其是女性和年龄超过 50 岁的患者。
