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传统和非传统脂质参数作为突发性聋的危险因素。

Traditional and non-traditional lipid parameters as risk factors for sudden sensorineural hearing loss.

机构信息

Shanghai Jiao Tong University School of Medicine affiliated Sixth People's Hospital, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.

Hangzhou Normal University, Zhejiang Province, China.

出版信息

Braz J Otorhinolaryngol. 2024 Jul-Aug;90(4):101435. doi: 10.1016/j.bjorl.2024.101435. Epub 2024 Apr 22.

Abstract

OBJECTIVE

The purpose was to explore the effects of traditional and non-traditional lipid parameters on Sudden Sensorineural Hearing Loss (SSNHL).

METHODS

The study included 452 patients diagnosed with SSNHL, among whom 206 patients had a level of hearing improvement ≥10 dB after one month of follow-up. A propensity score-matched (2:1) control group was used. Conditional and unconditional logistic regression were used to analyze the risk factors for SSNHL.

RESULTS

Patients with SSNHL had a higher risk of concomitant hypertension and elevated atherosclerogenic lipid levels, with apolipoprotein B and apolipoprotein E identified as independent risk factors for the onset of SSNHL. Additionally, the Lipid Comprehensive Index (LCI) was an independent risk factor for the degree of hearing loss. A positive linear correlation was revealed between triglyceride, non-high-density lipoprotein cholesterol, atherogenic index, Castelli risk index, atherogenic index of plasma, LCI and hearing loss. However, no linear relationship was observed between hearing gain and any lipid parameters. When Total Cholesterol (TC) was in the range of borderline high, the treatment effect was the best. However, the statistical significance disappeared upon adjusting for confounding factors.

CONCLUSION

Patients with SSNHL exhibited markedly dysregulated lipid metabolism. Elevated serum lipid levels may be a causative factor in auditory impairment and can influence the extent of hearing loss. Promptly improving cochlear microcirculation may benefit patients with borderline elevated TC.

摘要

目的

探讨传统和非传统脂质参数对突发性聋(SSNHL)的影响。

方法

该研究纳入了 452 例确诊为 SSNHL 的患者,其中 206 例患者在随访 1 个月后听力提高≥10dB。采用倾向性评分匹配(2:1)的对照组。采用条件和无条件逻辑回归分析 SSNHL 的危险因素。

结果

SSNHL 患者并发高血压和动脉粥样硬化脂质水平升高的风险较高,载脂蛋白 B 和载脂蛋白 E 是 SSNHL 发病的独立危险因素。此外,脂质综合指数(LCI)是听力损失程度的独立危险因素。甘油三酯、非高密度脂蛋白胆固醇、致动脉粥样硬化指数、卡斯特利风险指数、血浆致动脉粥样硬化指数、LCI 与听力损失之间存在正线性相关。然而,听力增益与任何脂质参数之间均无线性关系。当总胆固醇(TC)处于边缘高的范围内时,治疗效果最佳。然而,在调整混杂因素后,这种统计学意义消失了。

结论

SSNHL 患者表现出明显的脂质代谢紊乱。血清脂质水平升高可能是听力障碍的致病因素,并影响听力损失的程度。及时改善耳蜗微循环可能对边缘升高 TC 的患者有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1e/11096716/9741d8abe6ad/gr1.jpg

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