Significant association between osteoporosis and hearing loss: a systematic review and meta-analysis

Upala, Sikarin; Rattanawong, Pattara; Vutthikraivit, Wasawat; Sanguankeo, Anawin

doi:10.1016/j.bjorl.2016.08.012

Cited by 22 publications

(18 citation statements)

References 25 publications

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“…Teriparatide, notorious for causing positional vertigo, was also related to tinnitus and hearing loss. Moreover, previous studies demonstrated a probable association between osteoporosis and hearing loss (Upala et al, 2017), as well as a remarkably higher incidence of tinnitus in patients with osteoporosis (Kahveci et al, 2014). Few cases regarded other otologicals, and the onset of ototoxicity could be due to the route of administration or to a worsening of a pre-existing condition.…”

Section: Discussionmentioning

confidence: 94%

Ototoxic Adverse Drug Reactions: A Disproportionality Analysis Using the Italian Spontaneous Reporting Database

Cicala¹,

Cutroneo²,

Mocciaro³

et al. 2019

Front. Pharmacol.

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Introduction: The panorama of drug-induced ototoxicity has widened in the last decades; moreover, post-marketing data are necessary to gain a better insight on ototoxic adverse drug reactions (ADRs). The aim of this study was to perform an analysis of ADR reports describing drug-induced ototoxicity from the Italian spontaneous reporting system (SRS). Methods: As a measure of disproportionality, we calculated the reporting odds ratios (RORs) and 95% confidence intervals (CIs) with a case/non-case methodology. Cases were all suspected ADR reports regarding drug-induced ototoxicity collected into the Italian SRS from 2001 to 2017. Non-cases included all other ADRs reported in the same period. Results: Of 325,980 reports, 652 included at least one ototoxic ADR, compared with 325,328 non-cases. Statistically significant adjusted RORs were found for drugs for cardiovascular disorders, urologicals, teriparatide, amikacin, prulifloxacin, rifampicin and isoniazid, cisplatin, hormone antagonists, tacrolimus, pomalidomide, tramadol, and antidepressants. Significant adjusted RORs in relation to tinnitus were also observed for doxazosin (ROR 5.55, 95% CI 2.06–14.93), bisoprolol (4.28, 1.59–11.53), nebivolol (8.06, 3.32–19.56), ramipril (3.96, 2.17–7.23), irbesartan (19.60, 9.19–41.80), betamethasone (4.01, 1.28–12.52), moxifloxacin (4.56, 1.71–12.34), ethambutol (12.25, 3.89–38.57), efavirenz (16.82, 5.34–52.96), sofosbuvir/ledipasvir (5.95, 1.90–18.61), etoposide (7.09, 2.63–19.12), abatacept (6.51, 2.42–17.53), indometacin (6.30, 2.02–19.72), etoricoxib (5.00, 2.23–11.23), tapentadol (4.37, 1.09–17.62), and timolol combinations (23.29, 9.53–56.95). Moreover, significant adjusted RORs for hypoacusis regarded clarithromycin (3.95, 1.86–8.40), azithromycin (10.23, 5.03–20.79), vancomycin (6.72, 2.14–21.11), methotrexate (3.13, 1.00–9.81), pemetrexed (4.38, 1.40–13.76), vincristine (5.93, 1.88–18.70), vinorelbine (21.60, 8.83–52.82), paclitaxel (2.34, 1.03–5.30), rituximab (3.20, 1.19–8.63), interferon alfa-2b (17.44, 8.56–35.53), thalidomide (16.92, 6.92–41.38), and deferasirox (41.06, 20.07–84.01). Conclusions: This study is largely consistent with results from literature. Nevertheless, propafenone, antituberculars, hormone antagonists, teriparatide, tramadol, and pomalidomide are unknown for being ototoxic. Hypoacusis after the use of vinorelbine, methotrexate, and pemetrexed is unexpected, such as tinnitus related with etoposide, nebivolol, betamethasone, abatacept, sofosbuvir/ledipasvir, and tapentadol, but these considerations require further investigation to better define the risk due to the paucity of data. Moreover, physicians should be aware of the clinical significance of ototoxicity and be conscious about the importance of their contribution to spontaneous reporting.

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Section: Discussionmentioning

confidence: 94%

Ototoxic Adverse Drug Reactions: A Disproportionality Analysis Using the Italian Spontaneous Reporting Database

Cicala¹,

Cutroneo²,

Mocciaro³

et al. 2019

Front. Pharmacol.

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“…Kshithi et al [25] found that sensorineural hearing loss and pure tone thresholds were higher in osteoporotic women and the DPOAE results were significantly different. Upala S et al [26] suggest that there is a possible relationship between hearing loss and BMD in the meta-analysis. Jung DJ et al [27] did not find such a relationship in the study.…”

Section: Discussionmentioning

confidence: 98%

The effect of osteoporosis on cochlear function in postmenopausal women: An observational study

Koca¹

2018

Journal of Surgery and Medicine

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Aim: Hearing loss and osteoporosis are common geriatric syndromes. Evidence suggests that osteoporosis may have an effect on cochlear function in a small number of clinical trials. Here, cochlear function in osteoporosis patients was assessed by otoacoustic emission test (OAET) measurements. Methods: The study designed as cross-sectional and observational. Forty female patients were included in the postmenopausal period at the age of 40-75 years. Age, body mass index (BMI), vitamin D level were recorded in all patients. Audiometric threshold testing was used to measure air-and bone-conduction hearing sensitivity. Bone mineral density (BMD) of the hip and vertebra was measured using dual-energy X-ray absorptiometry (DEXA). According to vertebra L1-4 t score <-2.5 osteoporosis, -2.5 to -1 osteopenic, the group divided into two and all parameters were compared. Transiently evoked (TE), and distortion-product (DP) otoacoustic emissions were recorded. Results: The mean age of the whole group was 58.6 ± 7.9 years. Accordingly, TE left was significantly different in the higher frequency in the osteopenic group at 0.75 Hz (p = 0.015). In audiometric tests, only the osteopenic group at 6,000 Hz was significantly different in the higher frequency of both ears (p = 0.049 / p = 0.016). When the group divided into two according to femur t score <-1.0; TEright_3.5 (p = 0.04), TEright_overall (p = 0.030), TEleft_1.7.5 (p = 0.043) and TEleft_overall (p = 0.046), DPright_1 (p = 0.049) and DPleft_6 (p = 0.039) were observed to occur at higher frequencies in the osteoporotic group. Lomber t score was positively correlated with BMI (p = 0.042 / r = 0.288). BMI was lower in the osteoporotic group. The tympanogram results of all patients were Type A. The TE positivity rate (S / N> 3) was 60.8% and the DP positivity rate (S / N> 3) was 39.2%. Conclusion: According to hip BMD scores, osteopenic-osteoporotic (T scor <-1) group showed higher frequencies in both cochlear and hearing tests than normal subjects. The high frequencies in both OAET results and odiologic data in osteoporotic group support the adverse effect of osteoporosis on cochlear and hearing function. Individuals with hearing loss should be screened for osteoporosis. Keywords: Bone mineral density, Osteoporosis, Hearing loss, Cochlear function Öz Amaç: İşitme kaybı ve osteoporoz sık görülen geriatrik sendromlardandır. Az sayıda klinik çalışmada osteoporozun koklear fonksiyona etkisi olabileceği yönünde delil bulunmuştur. Burada osteoporoz hastalarında kohlear fonksiyon, otoaküstik emisyon test (OAET) ölçümleri ile değerlendirildi. Yöntemler: Çalışma kesitsel gözlemsel olarak diüzenlendi. Çalışmaya 40-75 yaş aralığında postmenapozal dönemde 50 kadın hasta dahil edildi. Tüm hastalarda yaş, vücut kitle indeksi (BMI), vitamin D düzeyi kayıt edildi. Hava ve kemik iletimli işitme hassasiyetini ölçmek için odiyometrik eşik testi kullanıldı. Kalça ve omurganın kemik mineral yoğunluğu (BMD) dual enerji X-ışını absorpsiyometri (DEXA) kullanılarak ölçüldü. Vertebra L1-4 t sko...

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“…Besides this role in sound transmission, the ossicles also influence the acoustic impedance matching and effectively amplify sound whose impedance is increased during transmission from air-filled middle ear to liquid-filled inner ear. (36) In humans, a high prevalence of hearing loss is also seen in patients with osteoporosis (37) and osteogenesis imperfecta. (38,39) Moreover, a significant correlation of BMD with conductive hearing capacity has been reported, (40) underlining a potential role of bone quality (especially mineralization) in hearing conduction.…”

Section: Discussionmentioning

confidence: 99%

Conductive Hearing Loss in the Hyp Mouse Model of X-Linked Hypophosphatemia Is Accompanied by Hypomineralization of the Auditory Ossicles

Delsmann

Seist

Stürznickel

et al. 2020

Journal of Bone and Mineral Research

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X-linked hypophosphatemia (XLH) is a hereditary musculoskeletal disorder caused by loss-of-function mutations in the PHEX gene. In XLH, increased circulating fibroblast growth factor 23 (FGF23) levels cause renal phosphate wasting and low concentrations of 1,25-dihydroxyvitamin D, leading to an early clinical manifestation of rickets. Importantly, hearing loss is commonly observed in XLH patients. We present here data from two XLH patients with marked conductive hearing loss. To decipher the underlying pathophysiology of hearing loss in XLH, we utilized the Hyp mouse model of XLH and measured auditory brain stem responses (ABRs) and distortion product otoacoustic emissions (DPOAEs) to functionally assess hearing. As evidenced by the increased ABR/DPOAE threshold shifts in the mid-frequency range, these measurements indicated a predominantly conductive hearing loss in Hyp mice compared to wild-type (WT) mice. Therefore, we carried out an in-depth histomorphometric and scanning electron microscopic analysis of the auditory ossicles. Quantitative backscattered electron imaging (qBEI) indicated a severe hypomineralization of the ossicles in Hyp mice, evidenced by lower calcium content (CaMean) and higher void volume (ie, porosity) compared to WT mice. Histologically, voids correlated with unmineralized bone (ie, osteoid), and the osteoid volume per bone volume (OV/BV) was markedly higher in Hyp mice than WT mice. The density of osteocyte lacunae was lower in Hyp mice than in WT mice, whereas osteocyte lacunae were enlarged. Taken together, our findings highlight the importance of ossicular mineralization for hearing conduction and point toward the potential benefit of improving mineralization to prevent hearing loss in XLH.

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Significant association between osteoporosis and hearing loss: a systematic review and meta-analysis

Abstract: Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.

Cited by 22 publications

References 25 publications

Ototoxic Adverse Drug Reactions: A Disproportionality Analysis Using the Italian Spontaneous Reporting Database

Ototoxic Adverse Drug Reactions: A Disproportionality Analysis Using the Italian Spontaneous Reporting Database

The effect of osteoporosis on cochlear function in postmenopausal women: An observational study

Conductive Hearing Loss in the Hyp Mouse Model of X-Linked Hypophosphatemia Is Accompanied by Hypomineralization of the Auditory Ossicles

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