Grimmichova Tereza, Verespejova Ludmila, Urbaniova Zuzana, Chovanec Martin, Hill Martin, Bilek Radovan
Institute of Endocrinology, Prague, Czech Republic.
Department of Internal medicine, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic.
PLoS One. 2025 Jan 30;20(1):e0305787. doi: 10.1371/journal.pone.0305787. eCollection 2025.
Hearing impairment can have major impacts on behavior, educational attainment, social status, and quality of life. In congenital hypothyroidism, the incidence of hearing impairment reaches 35-50%, while in acquired hypothyroidism there is a reported incidence of 25%. Despite this, knowledge of the pathogenesis, incidence and severity of hearing impairment remains greatly lacking. The aim of our study was to evaluate hearing in patients with acquired hypothyroidism.
30 patients with untreated and newly diagnosed peripheral hypothyroidism (H) and a control group of 30 healthy probands (C) were enrolled in the study. Biochemical markers were measured, including median iodine urine concentrations (IUC) µg/L. The hearing examination included a subjective complaint assessment, otomicroscopy, tympanometry, transitory otoacoustic emission (TOAE), tone audiometry, and brainstem auditory evoked potential (BERA) examinations. The Mann-Whitney U test, Fisher's Exact test and multivariate regression were used for statistical analysis.
The H and C groups had significantly different thyroid hormone levels (medians with 95% CI) TSH mU/L 13.3 (8.1, 19.3) vs. 1.97 (1.21, 2.25) p = 0 and fT4 pmol/L 10.4 (9.51, 11.1) vs. 15 (13.8, 16.7) p = 0. The groups did not significantly differ in age 39 (34, 43) vs. 41 (36,44) p = 0.767 and IUC 142 (113, 159) vs. 123 (101, 157) p = 0.814. None of the hearing examinations showed differences between the H and C groups: otomicroscopy (p = 1), tympanometry (p = 1), TOAE (p = 1), audiometry (p = 0.179), and BERA (p = 0.505).
We did not observe any hearing impairment in adults with acquired hypothyroidism, and there were no associations found between hearing impairment and the severity of hypothyroidism or iodine status. However, some forms of hearing impairment, mostly mild, were very common in both studied groups.
听力障碍会对行为、教育程度、社会地位和生活质量产生重大影响。在先天性甲状腺功能减退症中，听力障碍的发生率达到35%-50%，而在获得性甲状腺功能减退症中，报告的发生率为25%。尽管如此，对于听力障碍的发病机制、发生率和严重程度仍知之甚少。我们研究的目的是评估获得性甲状腺功能减退症患者的听力。
30例未经治疗的新诊断为外周性甲状腺功能减退症的患者（H组）和30名健康对照者（C组）纳入本研究。检测生化指标，包括尿碘中位数浓度（IUC）（μg/L）。听力检查包括主观症状评估、耳镜检查、鼓室图、瞬态耳声发射（TOAE）、纯音听力测定和脑干听觉诱发电位（BERA）检查。采用曼-惠特尼U检验、费舍尔精确检验和多因素回归进行统计分析。
H组和C组甲状腺激素水平有显著差异（中位数及95%可信区间），促甲状腺激素（TSH）（mU/L）分别为13.3（8.1，19.3）和1.97（1.21，2.25），p = 0；游离甲状腺素（fT4）（pmol/L）分别为10.4（9.51，11.1）和15（13.8，16.7），p = 0。两组在年龄（39岁（34，43）与41岁（36，44），p = 0.767）和IUC（142（113，159）与123（101，157），p = 0.814）方面无显著差异。听力检查中，H组和C组之间均无差异：耳镜检查（p = 1）、鼓室图（p = 1）、TOAE（p = 1）、听力测定（p = 0.179）和BERA（p = 0.505）。
我们未观察到获得性甲状腺功能减退症成年患者存在听力障碍，且未发现听力障碍与甲状腺功能减退症严重程度或碘状态之间存在关联。然而，某些形式的听力障碍，大多为轻度，在两个研究组中都很常见。
