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心血管风险与突发性感音神经性听力损失:一项系统评价与荟萃分析

Cardiovascular Risk and Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis.

作者信息

Simões João Filipe Carvalho Pereira Mano, Vlaminck Stephan, Seiça Raquel Maria Fino, Acke Frederic, Miguéis António Carlos Eva

机构信息

Department of Otorhinolaryngology, Centre Hospitalier de Mouscron, Mouscron, Belgium.

Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

出版信息

Laryngoscope. 2023 Jan;133(1):15-24. doi: 10.1002/lary.30141. Epub 2022 Apr 25.

Abstract

OBJECTIVES/HYPOTHESIS: It was previously suggested that patients with idiopathic sudden sensorineural hearing loss (ISSNHL) have a higher risk of cardiovascular disease. The aim of this study is to determine if ISSNHL patients have an increased cardiovascular risk by means of a systematic review and meta-analysis.

METHODS

A systematic literature review was performed using PubMed, Embase, Cochrane Libraries and Web of Science. Studies with a clear definition of ISSNHL, investigating an association between traditional vascular risk factors and ISSNHL were included. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, two reviewers extracted the data, assessed the risk of bias and performed the analysis of the collected evidence.

RESULTS

Nineteen case-control studies and two cohort studies were included (102,292 patients). Individual studies argued for higher prevalence of hypercholesterolemia, diabetes mellitus (DM) and higher blood pressure (HBP) in ISSNHL patients with a range of odds ratios (ORs) from 1.03 to 19. Pooled analysis of adjusted ORs revealed a significantly increased risk of ISSNHL for patients with hypertriglyceridemia (OR 1.54; 95% confidence interval [CI] 1.18-2.02) and high levels of total cholesterol (TC) (OR 2.09; 95% CI 1.52-2.87 after sensitivity analysis), but not for HBP, DM, or high levels of low- and high-density lipoproteins.

CONCLUSION

An association between higher vascular risk profile and ISSNHL seems apparent in high levels of triglycerides (TG) and TC, but more studies are needed to confirm this hypothesis due to the high levels of data heterogeneity in the literature.

LEVEL OF EVIDENCE

NA Laryngoscope, 133:15-24, 2023.

摘要

目的/假设:此前有研究表明,特发性突发性感音神经性听力损失(ISSNHL)患者患心血管疾病的风险更高。本研究旨在通过系统评价和荟萃分析来确定ISSNHL患者的心血管风险是否增加。

方法

使用PubMed、Embase、Cochrane图书馆和科学网进行系统的文献综述。纳入明确界定ISSNHL且研究传统血管危险因素与ISSNHL之间关联的研究。两名研究者遵循系统评价和荟萃分析的首选报告项目(PRISMA)指南提取数据、评估偏倚风险并对收集到的证据进行分析。

结果

纳入了19项病例对照研究和2项队列研究(共102,292例患者)。个别研究表明,ISSNHL患者中高胆固醇血症、糖尿病(DM)和高血压(HBP)的患病率较高,优势比(OR)范围为1.03至19。对调整后的OR进行汇总分析发现,高甘油三酯血症患者发生ISSNHL的风险显著增加(OR 1.54;95%置信区间[CI] 1.18 - 2.02),总胆固醇(TC)水平升高的患者也是如此(敏感性分析后OR 2.09;95% CI 1.52 - 2.87),但HBP、DM或低密度和高密度脂蛋白水平升高的患者并非如此。

结论

较高的血管风险特征与ISSNHL之间的关联在高甘油三酯(TG)和TC水平上似乎很明显,但由于文献中数据异质性较高,需要更多研究来证实这一假设。

证据水平

NA 喉镜,133:15 - 24,2023年。

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