高胰岛素血症对耳蜗功能的影响。

The effects of hyperinsulinemia on cochlear functions.

机构信息

Department of Internal Medicine, Başkent University Ankara Hospital, Ankara, Turkey.

Department of Otorhinolaryngology, Başkent University Ankara Hospital, Ankara, Turkey.

出版信息

Noise Health. 2020 Jul-Sep;22(106):70-76. doi: 10.4103/nah.NAH_41_20.

DOI:10.4103/nah.NAH_41_20

PMID:33402607

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8000137/

Abstract

CONTEXT

Hyperinsulinemia is the most common metabolic change associated with cochleovestibular diseases.

AIM

We aimed to investigate the auditory functions in hyperinsulinemic individuals.

SETTINGS AND DESIGN

A total of 164 patients were included in this case-control study. While 76 patients with insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR] of ≥2.5) constituted the case group, 88 patients with HOMA-IR values of <2.5 constituted the control group of the study.

MATERIAL AND METHODS

The 75 g oral glucose tolerance test, blood biochemistry tests, hormonal analysis, audiological assessment, electrocochleography (EcochG), and transient evoked otoacoustic emissions (TEOAE) testing were performed.

STATISTICAL ANALYSIS

One-way analysis of variance and Kruskal-Wallis analysis of variance were used for the comparison of the metabolic and ear parameters in the normal glucose tolerance (NGT), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) groups. The chi-square test was used to compare nominal variables. Spearman and Pearson correlation coefficients were used for the correlation analyses of continuous variables.

RESULTS

The pure tone audiometry at 0.5, 1, 2, and 4 kHz was better in the case group than in the control group. A positive correlation was found between HbA1c and right ear 0.5, 1, 4, and 8 kHz threshold values and left ear 2, 4, 6, and 8 kHz threshold values. A negative correlation was found between HbA1c and speech discrimination scores. The right ear 1.00 and 2.83 kHz TEOAE measurements in the individuals with NGT were found higher than those in patients with IGT, and the 1.42 kHz TEOAE measurements and reproducibility were found higher than those in patients with IFG. The left ear 1.00 and 1.42 kHz TEOAE measurements of the IGT patients were found lower than those of IFG and NGT patients.

CONCLUSION

We showed that hearing was worsening in hyperinsulinemic patients and prediabetic conditions were related to hearing function impairment.

摘要

背景

高胰岛素血症是与耳蜗前庭疾病相关的最常见代谢变化。

目的

我们旨在研究高胰岛素血症个体的听觉功能。

设置和设计

本病例对照研究共纳入 164 例患者。其中，76 例胰岛素抵抗患者（稳态模型评估的胰岛素抵抗 [HOMA-IR]≥2.5）为病例组，88 例 HOMA-IR 值<2.5 的患者为对照组。

材料和方法

进行 75g 口服葡萄糖耐量试验、血液生化检查、激素分析、听力学评估、电耳蜗图（EcochG）和瞬态诱发耳声发射（TEOAE）测试。

统计分析

采用单因素方差分析和 Kruskal-Wallis 方差分析比较正常糖耐量（NGT）、空腹血糖受损（IFG）和糖耐量受损（IGT）组的代谢和耳部参数。采用卡方检验比较名义变量。采用斯皮尔曼和皮尔逊相关系数分析连续变量的相关性。

结果

病例组患者的 0.5、1、2 和 4kHz 纯音听阈比对照组更好。HbA1c 与右耳 0.5、1、4 和 8kHz 阈值以及左耳 2、4、6 和 8kHz 阈值呈正相关。HbA1c 与言语辨别率呈负相关。NGT 个体的右耳 1.00 和 2.83kHz TEOAE 测量值高于 IGT 患者，1.42kHz TEOAE 测量值和可重复性高于 IFG 患者。IGT 患者的左耳 1.00 和 1.42kHz TEOAE 测量值低于 IFG 和 NGT 患者。