Hellenic Police Medical Center, Thessaloniki, Greece.
Hellenic Army Medical Corps, Kastoria, Greece.
Rheumatol Int. 2021 Apr;41(4):681-689. doi: 10.1007/s00296-021-04788-5. Epub 2021 Feb 3.
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can affect virtually any organ, including middle and/or inner ear. The objective of the current systematic review and meta-analysis was to investigate the association of SLE with the different subtypes of hearing loss. This systematic review and meta-analysis was conducted in agreement with the PRISMA guidelines. The review protocol was registered in the PROSPERO international prospective register of systematic reviews ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216353 ). A random effects model meta-analysis was carried out while heterogeneity was appraised by I. Subgroup analysis and sensitivity analysis were also performed. Nine studies comprising 7,654 SLE patients and 37,244 controls were included in this systematic review. Four of them were rated to a moderate rate of bias, while five of them were rated to a low rate of bias. SLE patients had significantly increased odds of sensorineural hearing loss (SNHL) compared with controls (OR 2.31; 95%CI 1.48-3.60; I = 0). SLE patients did not have significantly increased odds of Conductive Hearing Loss (CHL) (OR 1.30; 95% CI 0.23-7.45; I = 0). Only one study reported on the outcome of Mixed Hearing Loss (MHL) (3 events in SLE group vs. 0 events in control group). Subgroup analysis, based on study design and detection method of hearing loss also showed significantly increased odds of SNHL in SLE patients. The significantly increased odds of SNHL in SLE persisted even after sensitivity analysis. In conclusion, SLE is significantly associated with SNHL; SLE is not associated with CHL, while, due to lack of data, we could not reach a conclusion regarding the odds of MHL in SLE patients. Pure tone audiometry as a screening test and follow-up test in SLE patients could be of essence. Management and prognosis of hearing loss in SLE patients should be discussed.
系统性红斑狼疮（SLE）是一种全身性自身免疫性疾病，几乎可以影响任何器官，包括中耳和/或内耳。本系统评价和荟萃分析的目的是研究 SLE 与不同类型听力损失之间的关联。本系统评价和荟萃分析符合 PRISMA 指南进行。审查方案已在 PROSPERO 国际前瞻性系统评价注册中心（https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216353）注册。进行了随机效应模型荟萃分析，同时通过 I 评估异质性。还进行了亚组分析和敏感性分析。本系统评价纳入了 9 项研究，共纳入 7654 例 SLE 患者和 37244 例对照。其中 4 项研究的偏倚风险评分为中度，5 项研究的偏倚风险评分为低度。与对照组相比，SLE 患者发生感音神经性听力损失（SNHL）的几率显著增加（OR 2.31；95%CI 1.48-3.60；I=0）。SLE 患者发生传导性听力损失（CHL）的几率无显著增加（OR 1.30；95%CI 0.23-7.45；I=0）。仅有 1 项研究报告了混合性听力损失（MHL）的结局（SLE 组 3 例，对照组 0 例）。基于听力损失的研究设计和检测方法的亚组分析也显示，SLE 患者发生 SNHL 的几率显著增加。即使在敏感性分析后，SLE 患者 SNHL 几率显著增加的结果仍然存在。总之，SLE 与 SNHL 显著相关；SLE 与 CHL 无关，但由于数据缺乏，我们无法得出 SLE 患者发生 MHL 的几率的结论。纯音测听作为 SLE 患者的筛查试验和随访试验可能很重要。应讨论 SLE 患者听力损失的管理和预后。
