Determinants of Residual Dizziness in BPPV Patients After Effective Repositioning Maneuvers: The Mediating Role of Blood Lipid Levels in a Single-Center Analysis

Abstract

Objective To explore the independent risk factors for residual dizziness in benign paroxysmal positional vertigo (BPPV) patients following successful repositioning maneuvers, and further examine whether different lipid-related indicators act as mediators between these risk factors and residual dizziness. Methodology: 110 patients diagnosed with BPPV and treated with repositioning maneuvers were recruited between January 2019 and February 2022. The general data and lipid-related data from both patients with residual dizziness and without residual dizziness. Multivariate logistic regression models were used to evaluate risk factors for residual dizziness in BPPV patients, adjusting for demographic variables, underlying diseases, behavioral factors, and lipid-related indicators. Simultaneously, utilizing regression-based mediation analyses, both the immediate impact of the reported statistically significant risk factors on the residual dizziness and the subsequent indirect influence mediated through lipid-related indicators were investigated. Odds ratios (OR) and 95% confidence intervals (CIs) were reported. Results Significant differences were observed between groups with and without residual dizziness in terms of limb weakness, hypertension, nausea, limb arteriosclerosis, medication treatment, DHI scores, HADS scores, and distributions of TC, LDL, and HDL (P < 0.05). Multivariate logistic regression analysis identified sleep disorders (OR: 1.28, 95% CI: 1.06–1.50), medication treatment (OR: 2.57, 95% CI: 2.03–3.02), hypertension (OR: 3.33, 95% CI: 2.90–4.22), Triglyceride (TG, OR: 1.05, 95% CI: 1.02–1.12), and total cholesterol (TC, OR: 1.12, 95% CI: 1.05–1.26) as significant risk factors for residual dizziness after adjusting for all cofounders(P < 0.05). Additionally, a mediating effect of 9.1% for total cholesterol blood concentration between sleep disorders and residual dizziness was revealed. Conclusions Our findings highlight the significant risk factors for residual dizziness. We also found that TC blood concentration mediates the relationship between sleep disorders and residual dizziness by 9.1%. These insights emphasize the need to address lipid levels and sleep disorders in managing residual dizziness in BPPV patients after effective repositioning maneuvers.