Estradiol deficiency is a risk factor for idiopathic benign paroxysmal positional vertigo in postmenopausal female patients

Yang, Hualan; Gu, Hongbin; Sun, Wenjing; Li, Yanpeng; Wu, Huijuan; Burnee, Molorerdene; Zhuang, Jianhua

doi:10.1002/lary.26628

Cited by 30 publications

(27 citation statements)

References 32 publications

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“…Previous studies have also suggested that women had a higher incidence of BPPV than in men, especially in the elderly women (4). This relationship may be related to estrogen deficiency in postmenopausal women, as estrogen may promote the development of osteoporosis and even BPPV (18). In addition, women BPPV patients have a higher risk of recurrence than men (9,31).…”

Section: Discussionmentioning

confidence: 97%

“…However, the underlying causes of BPPV remain unclear. In recent decades, many studies have investigated risk factors for the occurrence of BPPV, including female gender, serum vitamin D deficiency, osteoporosis, vascular risk factors, head trauma, and other potential risk factors (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). However, there are some controversies among these studies.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

et al. 2020

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Background and Purpose: The lifetime prevalence of benign paroxysmal positional vertigo (BPPV) is high, especially in the elderly. Patients with BPPV are more susceptible to ischemic stroke, dementia, and fractures, severely reducing quality of life of patients. Many studies have analyzed risk factors for the occurrence of BPPV. However, the results of these studies are not identical. We performed this meta-analysis to determine potential risk factors associated with the occurrence of BPPV. Methods: PubMed, EMBASE, and the Cochrane Library (January 2000 through March 2020) were systematically searched for eligible studies analyzing risk factors for the occurrence of BPPV. Reference lists of eligible studies were also reviewed. We selected observational studies in English with a control group and sufficient data. Pooled odds ratios (ORs) or the mean differences (MDs) and 95% confidence intervals (CIs) were calculated to measure the impacts of all potential risk factors. Heterogeneity among studies was evaluated using the Q-test and I 2 statistics. We used the randomeffect model or the fixed-effect model according to the heterogeneity among the included studies. Results: We eventually included 19 studies published between 2006 and 2019, including 2,618 patients with BPPV and 11,668 participants without BPPV in total. In this meta-analysis, the occurrence of BPPV was significantly associated with female gender (OR = 1.18; 95% CI, 1.05-1.32; P = 0.004), serum vitamin D level (MD = −2.12; 95% CI, −3.85 to −0.38; P = 0.02), osteoporosis (OR = 2.49; 95% CI, 1.39-4.46; P = 0.002), migraine (OR = 4.40; 95% CI, 2.67-7.25; P < 0.00001), head trauma (OR = 3.42; 95% CI, 1.21-9.70; P = 0.02), and total cholesterol level (MD = 0.32; 95% CI, 0.02-0.62; P = 0.03). Conclusion: Female gender, vitamin D deficiency, osteoporosis, migraine, head trauma, and high TC level were risk factors for the occurrence of BPPV. However, the effects of other risk factors on BPPV occurrence need further investigations.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

et al. 2020

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“…Similar findings were reported by Coksuer et al, the vertigo symptom gone after took hormone therapy (Coksuer et al, 2011 ). Furthermore, Yang et al conducted an animal study and the result showed the bilateral ovariectomy rat accepted female sex hormone replacement therapy were reversed the decrease of otoconin 90 levels (Yang et al, 2017 ). Otoconin 90 acts as main protein to maintain the normal morphology and growth of otoconia (Petko et al, 2008 ).…”

Section: Discussionmentioning

confidence: 99%

Age-Related Increases in Benign Paroxysmal Positional Vertigo Are Reversed in Women Taking Estrogen Replacement Therapy: A Population-Based Study in Taiwan

Liu

Kuo

Wang

et al. 2017

Front. Aging Neurosci.

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Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. Numerous investigations have reported an increased BPPV incidence in females and in the aged population. The hormonal characteristics of BPPV patients have not been previously investigated. This study aimed to determine the risk of BPPV in relation to menopause in a population-based study.Materials and Methods: This retrospective population-based study was designed to use a nationwide longitudinal health insurance database to follow and analyze the incidence of and protective factors against BPPV in a Taiwanese population.Data Analyses: Univariate and multivariate analyses were performed to calculate the adjusted hazard ratio (aHR) for the incidence of BPPV using Cox-proportional regression models.Results: In the multivariate analyses, we found that older people (older than 65 years old) were more prone to develop BPPV (aHR: 5.37, 95% CI: 0 4.83–5.97, p < 0.001). The risk of BPPV was analyzed in two specific age subgroups of elderly females. Results revealed that in both age groups (45–65 years old and >65 years old), patients who took estrogen for menopausal syndromes had a significantly lower incidence of BPPV (aHR; 0.01, 95% CI: 0.06–0.23, p < 0.001).Conclusion: Our study provides a novel etiology and possible treatment method for the prevention of BPPV. Further studies may focus on the pathophysiological mechanism of estrogen in BPPV patients and the development of new drugs for the prevention and treatment of BPPV.

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“…Otoconia had loose morphology and were occasionally displaced into the semicircular canals in otoconin 90-null mice ( 25 ). Otoconin 90 expression levels were decreased in bilateral ovariectomy rats, while estrogen replacement reversed the decrease of otoconin 90 levels ( 26 ). Furthermore, bilaterally ovariectomised mice have significant balance-related behavioral deficits and that estrogen deficiency compromises otoconia maintenance and anchoring by reducing the expression of the otoconial component and anchoring proteins ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Bone Metabolism in Male Patients With Benign Paroxysmal Positional Vertigo

Fan

Jin

et al. 2018

Front. Neurol.

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Objective: Several studies have suggested a probable association between benign paroxysmal positional vertigo (BPPV) and both reduction of bone mineral density (BMD) and serum vitamin D levels, but none of these studies have explored their findings by examining bone turnover markers (BTM) in male idiopathic BPPV patients. This study aimed to evaluate the relationship between BMD and serum 25-hydroxyvitamin D (25(OH) D), with the occurrence of BPPV along with the characteristics of bone metabolism in male idiopathic BPPV patients.Methods: This retrospective study comprised 60 male idiopathic BPPV patients and 92 age-matched healthy controls referred to Ningbo No.2 Hospital during the period of February 2016 to February 2018. All subjects' serum levels of 25(OH) D, bone formation marker amino-terminal propeptide of type I procollagen (PINP), and bone resorption marker β-isomerized carboxy-terminal telopeptide of type I collagen (β-CTX) were measured. BMD was determined by dual energy X-ray absorption at the lumbar spine and hip.Results: Among male patients with BPPV, the prevalence of BMD reduction was 35.0%, which was similar to that of 27.2% in healthy controls. There were significant differences in the mean serum 25(OH) D level and prevalence of vitamin D deficiency between the two groups, with p-values of 0.049 and 0.009, respectively. The bone turnover markers of PINP and β-CTX in BPPV patients were lower than those in healthy controls. Logistic regression showed that vitamin D deficiency were associated with BPPV with an odds ratio of 3.8 (95% confidence interval = 1.25–11.73).Conclusion: Our study found that decreased serum vitamin D may be a risk factor for BPPV in male patients. The level of bone turnover among male patients with BPPV was lower than that among healthy controls.

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Estradiol deficiency is a risk factor for idiopathic benign paroxysmal positional vertigo in postmenopausal female patients

Abstract: NA. Laryngoscope, 128:948-953, 2018.

Cited by 30 publications

References 32 publications

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

Age-Related Increases in Benign Paroxysmal Positional Vertigo Are Reversed in Women Taking Estrogen Replacement Therapy: A Population-Based Study in Taiwan

Assessment of Bone Metabolism in Male Patients With Benign Paroxysmal Positional Vertigo

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