Department of Ophthalmology, Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Otorhinolaryngology Research Center, Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Am J Otolaryngol. 2022 Mar-Apr;43(2):103383. doi: 10.1016/j.amjoto.2022.103383. Epub 2022 Feb 2.
Microvascular involvement in patients with diabetes mellitus is one of the causes of retinopathy, nephropathy, and neuropathy. The same pathologic processes may occur in the inner ear structures. This case-control study aimed to evaluate the hearing thresholds in type 2 diabetic patients with different severity of diabetic retinopathy (DR) and to compare these findings with controls.
We evaluated the hearing threshold in four groups of eligible subjects aged 20-70 years. These groups were controls, diabetic patients with no-DR, with mild-moderate non-proliferative DR (NPDR), and with severe NPDR/proliferative DR (PDR). Each group consisted of 105 subjects. Speech-frequency and high-frequency hearing levels (SFHL and HFHL, respectively) were measured and log-transformed. Analysis of covariance was used. The prevalence rate of moderate or more hearing loss in the groups was estimated.
In total, 194 men and 226 women participated. The ratio of means of SFHL and HFHL between PDR and controls was 0.18 and 0.20, respectively. Hearing loss was prevalent in severe NPDR/PDR (adjusted prevalence ratio 3.36 for SFHL and 1.51 for HFHL) compared to controls. Also, the prevalence of high-frequency hearing loss was more in mild-moderate NPDR (adjusted prevalence ratio 1.33).
The magnitude of the increase in hearing impairment prevalence between the severe NPDR/PDR patients and controls was about 24% for both SFHL and HFHL. We recommend hearing assessment in the screening of the DR patients.
糖尿病患者的微血管病变是导致视网膜病变、肾病和神经病变的原因之一。同样的病理过程也可能发生在内耳结构中。本病例对照研究旨在评估不同严重程度糖尿病视网膜病变（DR）的 2 型糖尿病患者的听力阈值，并将这些发现与对照组进行比较。
我们评估了年龄在 20-70 岁之间的四个符合条件的受试者组的听力阈值。这些组为对照组、无 DR 的糖尿病患者、轻度中度非增生性 DR（NPDR）和严重 NPDR/增生性 DR（PDR）的糖尿病患者。每个组由 105 名受试者组成。测量了言语频率和高频听力水平（SFHL 和 HFHL），并进行了对数转换。使用协方差分析。估计了各组中度或更严重听力损失的患病率。
共有 194 名男性和 226 名女性参与。PDR 组和对照组之间 SFHL 和 HFHL 的均值比分别为 0.18 和 0.20。与对照组相比，严重 NPDR/PDR 组听力损失更为常见（SFHL 的调整患病率比为 3.36，HFHL 的调整患病率比为 1.51）。此外，轻度中度 NPDR 组高频听力损失的患病率更高（调整患病率比为 1.33）。
严重 NPDR/PDR 患者与对照组之间听力障碍患病率增加的幅度大约为 SFHL 和 HFHL 的 24%。我们建议在 DR 患者的筛查中进行听力评估。
