Chen Xiaoyan, Zheng Zhong, Xiao Lili, Liu Chengqi, Shen Ying, Ma Ning, Dong Hongjun, Yin Shankai, Feng Yanmei
Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Front Neurol. 2022 Aug 25;13:980150. doi: 10.3389/fneur.2022.980150. eCollection 2022.
This study aims to explore the relationship between bone-turnover biomarkers and the recovery of SSNHL to provide clues for further improvements in etiological research and predictors.
The medical history, hearing thresholds, biomarkers of bone-turnover, and related hormones of 117 SSNHL patients were collected prospectively between August 2018 and December 2021. Linear correlation and logistic regression models were applied to examine the association between bone-turnover biomarkers and the prognosis of SSNHL.
Age, the incidence of vertigo, pure tone average of the impaired frequencies (PTA), and the levels of bone turnover [including alkaline phosphatase (ALP), β-carboxy terminal crosslinked telopeptide of type 1 collagen (β-CTX), and N-terminal-midfragment of osteocalcin (N-MID)] were higher in the nonresponders than responders ( < 0.05). Logistic regression showed that the age (OR = 1.035, = 0.027), time to treatment (OR = 1.157, = 0.038), PTA (OR = 1.031, = 0.008), and β-CTX (OR = 1.004, = 0.001) were independent risk factors for the prognosis of SSNHL. In the women SSNHL subgroup, age, postmenopause percentage, PTA, the activity of ALP, levels of β-CTX, and N-MID were significantly higher in the nonresponders than the responders ( < 0.05). Compared to the men SSNHL subgroup, β-CTX has a higher correlation coefficient and predictive efficiency in the women SSNHL subgroup, and logistic regression showed that β-CTX (OR = 1.004, = 0.004) was an independent risk factor for the women SSNHL.
Bone-turnover biomarkers are risk factors for poor prognosis in SSNHL, especially β-CTX. The differences were significant in women SSNHL, which may be related to the rapid regression of estrogen after menopause that leads to the occurrence of osteoporosis with a high conversion rate.
本研究旨在探讨骨转换生物标志物与突发性聋伴眩晕（SSNHL）恢复之间的关系，为病因学研究和预测指标的进一步改进提供线索。
前瞻性收集2018年8月至2021年12月期间117例SSNHL患者的病史、听力阈值、骨转换生物标志物及相关激素。应用线性相关和逻辑回归模型来检验骨转换生物标志物与SSNHL预后之间的关联。
无反应者的年龄、眩晕发生率、受损频率的纯音平均值（PTA）以及骨转换水平[包括碱性磷酸酶（ALP）、Ⅰ型胶原β羧基末端交联肽（β-CTX）和骨钙素N端中段（N-MID）]均高于有反应者（P<0.05）。逻辑回归显示，年龄（OR = 1.035，P = 0.027）、治疗时间（OR = 1.157，P = 0.038）、PTA（OR = 1.031，P = 0.008）和β-CTX（OR = 1.004，P = 0.001）是SSNHL预后的独立危险因素。在女性SSNHL亚组中，无反应者的年龄、绝经后百分比、PTA、ALP活性、β-CTX和N-MID水平显著高于有反应者（P<0.05）。与男性SSNHL亚组相比，β-CTX在女性SSNHL亚组中的相关系数和预测效率更高，逻辑回归显示β-CTX（OR = 1.004，P = 0.004）是女性SSNHL的独立危险因素。
骨转换生物标志物是SSNHL预后不良的危险因素，尤其是β-CTX。在女性SSNHL中差异显著，这可能与绝经后雌激素迅速下降导致高转化率骨质疏松的发生有关。
