Department of Otorhinolaryngology, Leiden University Medical Center, Leiden, The Netherlands.
Apeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, The Netherlands.
Audiol Neurootol. 2024;29(1):1-29. doi: 10.1159/000530686. Epub 2023 Aug 9.
Vascular involvement in the pathophysiology of idiopathic sudden sensorineural hearing loss (iSSNHL) has been previously proposed. The objective of this study was to perform a systematic review of the current literature and conduct meta-analyses to evaluate associations between cardiovascular risk factors, cerebral small vessel disease, and subsequent stroke after presentation with iSSNHL. Three systematic literature reviews and meta-analyses were conducted using PubMed, Embase, and CINAHL. All studies investigating associations between iSSNHL and the cardiovascular risk factors: body mass index (BMI), diabetes mellitus, hyperlipidemia, hypertension, medical history of myocardial infarction (MI), smoking, the degree of white matter hyperintensities, and incidence of stroke were included. Adhering to the PRISMA guidelines, two independent reviewers reviewed the articles and assessed risk of bias. The cardiovascular risk factors of abnormal BMI, diabetes, hypertension, total cholesterol, low-density lipoprotein cholesterol, and a medical history of MI were significantly associated with iSSNHL. The adjusted hazard ratio of a higher degree of white matter hyperintensities was 0.70 (95% CI 0.44, 1.12). Patients with iSSNHL showed a higher risk of stroke compared to controls, with hazard ratios ranging from 1.22 up to 4.08. Several cardiovascular risk factors are more frequently present in patients with iSSNHL than in the general population. The degree of white matter hyperintensities does not appear to be increased in patients with iSSNHL, while the risk of stroke following ISSNHL is increased. Prospective studies with larger study populations are needed to confirm the associations between generalized cardiovascular disease and iSSNHL and to assess whether these patients benefit from cardiovascular risk management to prevent future cardiovascular and cerebrovascular disease.
血管参与特发性突发性聋（ISSNHL）的病理生理学已经被提出。本研究的目的是对现有文献进行系统评价，并进行荟萃分析，以评估心血管危险因素、脑小血管疾病与 ISSNHL 后中风之间的相关性。使用 PubMed、Embase 和 CINAHL 进行了三项系统文献综述和荟萃分析。所有研究均调查了 ISSNHL 与心血管危险因素之间的相关性：体重指数（BMI）、糖尿病、高脂血症、高血压、心肌梗死（MI）病史、吸烟、脑白质高信号程度和中风发生率。本研究遵循 PRISMA 指南，两名独立审查员对文章进行了回顾并评估了偏倚风险。异常 BMI、糖尿病、高血压、总胆固醇、低密度脂蛋白胆固醇和 MI 病史等心血管危险因素与 ISSNHL 显著相关。脑白质高信号程度较高的调整后危险比为 0.70（95%CI 0.44，1.12）。与对照组相比，ISSNHL 患者中风的风险更高，风险比范围从 1.22 到 4.08。与一般人群相比，ISSNHL 患者更常存在几种心血管危险因素。ISSNHL 患者的脑白质高信号程度似乎没有增加，而 ISSNHL 后中风的风险增加。需要进行具有更大研究人群的前瞻性研究，以确认全身性心血管疾病与 ISSNHL 之间的相关性，并评估这些患者是否受益于心血管风险管理，以预防未来的心血管和脑血管疾病。
