Seidel David Ulrich, Bode Simon, Kostev Karel
Department of Otorhinolaryngology, Facial Plastic Surgery, Klinikum Oberberg, 51643 Gummersbach, Germany.
University Hospital, Philipps University, 35043 Marburg, Germany.
Audiol Res. 2025 Aug 9;15(4):102. doi: 10.3390/audiolres15040102.
Numerous studies have demonstrated the beneficial effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on cardiovascular and renal outcomes in patients with heart failure and chronic kidney disease. However, whether SGLT2 inhibitors are also associated with a reduced risk of tinnitus has not been investigated.
This study aimed to investigate the association between SGLT2 inhibitor therapy and the incidence of tinnitus in patients with type 2 diabetes.
This retrospective cohort study was based on data from a nationally representative database of primary care practices in Germany from 2012 to 2023. Patients with type 2 diabetes who were treated with metformin and additionally received either an SGLT2 inhibitor or a dipeptidyl peptidase-4 (DPP4) inhibitor were included. Patients with a previous diagnosis of tinnitus were excluded. The primary outcome was the first tinnitus diagnosis documented by a primary care physician. The SGLT2 and DPP4 cohorts were compared for tinnitus incidence using Kaplan-Meier analysis and multivariable Cox regression.
66,750 patients with SGLT2 inhibitors and 82,830 with DPP4 inhibitors were analyzed. The cumulative 5-year incidence of tinnitus was 1.9% in both groups. The multivariable regression analysis did not show a significant association between SGLT2 therapy and the occurrence of a tinnitus diagnosis (HR: 1.04; 95% CI: 0.89-1.21).
There was no difference in tinnitus incidence between patients with SGLT2 or DPP4 inhibitors. The causes could lie in the heterogeneous, not purely vascular, etiology of tinnitus in general practitioners' practices. Future studies should include further clinical data, including confirmed hearing impairments.
大量研究已证实钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂对心力衰竭和慢性肾病患者的心血管及肾脏结局具有有益作用。然而，SGLT2抑制剂是否也与耳鸣风险降低相关尚未得到研究。
本研究旨在探讨SGLT2抑制剂治疗与2型糖尿病患者耳鸣发生率之间的关联。
这项回顾性队列研究基于2012年至2023年德国全国代表性基层医疗实践数据库中的数据。纳入接受二甲双胍治疗且额外接受SGLT2抑制剂或二肽基肽酶-4（DPP4）抑制剂治疗的2型糖尿病患者。排除既往有耳鸣诊断的患者。主要结局是基层医疗医生记录的首次耳鸣诊断。使用Kaplan-Meier分析和多变量Cox回归比较SGLT2和DPP4队列的耳鸣发生率。
分析了66750例使用SGLT2抑制剂的患者和82830例使用DPP4抑制剂的患者。两组的耳鸣累积5年发生率均为1.9%。多变量回归分析未显示SGLT2治疗与耳鸣诊断的发生之间存在显著关联（HR：1.04；95%CI：0.89-1.21）。
使用SGLT2或DPP4抑制剂的患者在耳鸣发生率上没有差异。原因可能在于全科医疗实践中耳鸣病因的异质性，而非单纯血管性病因。未来的研究应纳入更多临床数据，包括确诊的听力障碍。
