Endocrinology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, Maryland, USA.
Diabetes Metab Res Rev. 2020 Sep;36(6):e3312. doi: 10.1002/dmrr.3312. Epub 2020 Apr 19.
We examined the hearing function in adults with and without type 1 diabetes (T1D) to investigate whether an association exists between hearing loss and duration of diabetes, haemoglobin A1C level, diabetes complications and levels of select serum and urinary biomarkers.
We measured pure tone audiometry (PTA) thresholds; serum levels of C-reactive protein (CRP), vascular endothelial growth factor (VEGF), soluble receptors for advanced glycation end-product (sRAGE); and urinary isoprostane in 30 adults with T1D (age 43.8 ± 11.4 years). We also measured PTA thresholds in 11 adults without diabetes (age 53 ± 5.5 years).
63.3% of adults with T1D had high-frequency hearing loss. Among adults with T1D, those with hearing loss were older (48.2 vs 36.2 years old, P < .01), had a longer duration of diabetes (30.7 vs 21.2 years, P = .02), a greater prevalence of peripheral neuropathy (57.9 vs 9.1%, P = .02) and significantly lower median levels of sRAGE (1054.27 vs 1306.83 pg/mL, P = .03) compared to those with normal hearing. Adults with T1D between the ages of 40 and 60 years old, who had diabetes for ≥35 years, had significantly higher PTA thresholds at both 500and 8000 Hz than age-matched adults without diabetes.
A significant proportion of adults with T1D have high-frequency hearing loss before age of 60 that is positively associated with age, duration of diabetes and presence of peripheral neuropathy. Our results are in support of previous studies suggesting a potential protective role of sRAGE against AGE toxicity and diabetes complications.
本研究旨在探讨糖尿病病程、糖化血红蛋白（HbA1c）水平、糖尿病并发症以及某些血清和尿液生物标志物水平与 1 型糖尿病（T1D）患者听力损失之间的相关性，对伴有和不伴有 T1D 的成年人的听力功能进行了检测。
我们对 30 例 T1D 患者（年龄 43.8±11.4 岁）和 11 例无糖尿病的成年人（年龄 53±5.5 岁）进行了纯音听阈测试（PTA）、血清 C 反应蛋白（CRP）、血管内皮生长因子（VEGF）、晚期糖基化终产物可溶性受体（sRAGE）和尿液 8-异前列腺素的检测。
63.3%的 T1D 患者存在高频听力损失。与听力正常的 T1D 患者相比，有听力损失的 T1D 患者年龄更大（48.2 岁 vs 36.2 岁，P<.01）、糖尿病病程更长（30.7 年 vs 21.2 年，P=0.02）、周围神经病变发生率更高（57.9% vs 9.1%，P=0.02），sRAGE 中位数水平更低（1054.27 pg/ml vs 1306.83 pg/ml，P=0.03）。年龄在 40-60 岁之间、糖尿病病程≥35 年的 T1D 患者，其 500Hz 和 8000Hz 的 PTA 阈值明显高于年龄匹配的无糖尿病患者。
相当一部分 T1D 患者在 60 岁之前就出现高频听力损失，且该现象与年龄、糖尿病病程及周围神经病变呈正相关。我们的研究结果支持了之前的研究结果，即 sRAGE 可能具有对抗 AGE 毒性和糖尿病并发症的保护作用。
