Metabolic Syndrome Increases the Risk of Sudden Sensorineural Hearing Loss in Taiwan

Chien, Chen‐Yu; Tai, Shu‐Yu; Wang, Ling‐Feng; Hsi, Edward; Chang, Ning-Chia; Wu, Ming Tsang; Ho, Kuen‐Yao

doi:10.1177/0194599815575713

Cited by 54 publications

(82 citation statements)

References 27 publications

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“…These co-morbidities might interfere with the microvascular supply of the inner ear and lead to hearing loss. Although their effect on prognosis of the disease is not well established, it may be speculated that negative prognostic effect may occur (17,18). Thus, despite steroids seeming to have no additional benefit in this paper, studies on more homogenous patient populations might contribute to the knowledge.…”

Section: Discussionmentioning

confidence: 81%

“…The negative prognostic effect of profound or total hearing loss is almost agreed worldwide. However, in the literature, there are certain studies which report poor prognosis with flat type or low frequency losses which is an inconsistent finding with the majority of the rest (18,25). This might be attributable, to a certain point, to various classification patterns or diverse treatment modalities utilized by different authors.…”

Section: Discussionmentioning

confidence: 98%

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Prognostic Factors in Sudden Sensorineural Hearing Loss

Atay¹,

Kayahan²,

Çınar³

et al. 2016

Balkan Med J

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Background: Sudden sensorineural hearing loss (SSNHL) is still a complex and challenging process which requires clinical evidence regarding its etiology, treatment and prognostic factors. Therefore, determination of prognostic factors might aid in the selection of proper treatment modality. Aims: The aim of this study is to analyze whether there is correlation between SSNHL outcomes and (1) systemic steroid therapy, (2) time gap between onset of symptoms and initiation of therapy and (3) audiological pattern of hearing loss. Study Design: Retrospective chart review. Methods: Patients diagnosed at our clinic with SSNHL between May 2005 and December 2011were reviewed. A detailed history of demographic features, side of hearing loss, previous SSNHL and/or ear surgery, recent upper respiratory tract infection, season of admission, duration of symptoms before admission and the presence of co-morbid diseases was obtained. Radiological and audiological evaluations were recorded and treatment protocol was assessed to determine whether systemic steroids were administered or not. Treatment started ≤5 days was regarded as "early" and >5 days as "delayed". Initial audiological configurations were grouped as "upward sloping", "downward sloping", "flat" and "profound" hearing loss. Significant recovery was defined as thresholds improved to the same level with the unaffected ear or improved ≥30 dB on average. Slight recovery was hearing improvement between 10-30dB on average. Hearing recovery less than 10 dB was accepted as unchanged. Results: Among the 181 patients who met the inclusion criteria, systemic steroid was administered to 122 patients (67.4%), whereas 59 (32.6%) patients did not have steroids. It was found that steroid administration did not have any statistically significant effect in either recovered or unchanged hearing groups. Early treatment was achieved in 105 patients (58%) and 76 patients (42%) had delayed treatment. Recovery rates were no different in these two groups; however, when unchanged hearing rates were compared, it was statistically significantly lower in the early treatment group (p<0.05). When hearing outcomes were compared according to initial audiological pattern, significant recovery and unchanged hearing rates did not differ between groups; however, slight recovery rate was highest in the "flat" type audiological configuration (p<0.05). Conclusion: According to this patient series, oral steroid therapy does not have any influence on the outcomes of SSNHL. However, mid-frequency hearing loss of flat type and initiation of treatment earlier than 5 days from the onset of symptoms, seem to have positive prognostic effects. Further randomized controlled subject groups might contribute to determine prognostic factors of SSNHL.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 98%

Prognostic Factors in Sudden Sensorineural Hearing Loss

Atay¹,

Kayahan²,

Çınar³

et al. 2016

Balkan Med J

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“…Age ( p = 0.003), vertigo ( p = 0.006), and initial hearing loss ( p < 0.001) were positively correlated with final outcome, while BMI ( p = 0.23), tinnitus ( p = 0.30) and sex ( p = 0.878) were not. Other data (severity of hearing loss, time to treatment, BMI, vertigo) were identified as negative prognostic factors of SISHL in other trials [22–25]. When we performed the same analysis adjusted for therapeutic benefit (difference between initial and final hearing loss), only patients with higher initial hearing loss showed a significant positive correlation with hearing improvement ( p < 0.001).…”

Section: Discussionmentioning

confidence: 77%

“…Vascular compromise and associated cochlear ischemia are thought to be contributory to SISHL in some cases, or could be a final common pathway to hearing loss. And indeed atherosclerotic and rheological risk factors (hypercholesterolemia [20–22], hyperfibrinogenemia [23], age [24], BMI [22], metabolic syndrome [25] or hyperhomocysteinemia [26]) have recently been proven to be important in the etiology and prognosis of SISHL, although not all studies support such evidence [27, 28]. When analyzing our data, we cannot confirm an elevated baseline level of LDL-cholesterol, fibrinogen or viscosity in SISHL patients.…”

Section: Discussionmentioning

confidence: 99%

Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss

Košťál

Dršata

Bláha

et al. 2017

J of Otolaryngol - Head & Neck Surg

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BackroundOnly few therapeutic options exist for patients with refractory sudden idiopathic sensorineural hearing loss (SISHL). Little is known about the efficacy of second-line therapies. Rheopheresis seems to be an effective therapeutic possibility.MethodsBetween 2012 and 2015, 106 patients with SISHL were enrolled in the study, of whom 52 were refractory to initial treatment. As salvage therapy, these patients were offered either 3 sessions of rheopheresis (33 pts) or intratympanic steroid treatment through MicroWick application (19 pts). Pure tone audiometry was performed at diagnosis, at the 1st month and the 1st year during the follow-up.ResultsPatients in the rheopheretic arm had higher hearing loss than in the MicroWick arm (81% vs. 52%, p = 0.04). In spite of this, there was a significant improvement for patients in the rheopheretic arm (27% of hearing loss reduction, p < 0.001) after the 1st month and this remained unchanged during the 1st year, while no improvement was seen in the MicroWick arm (0% of hearing loss reduction, p = 0.424). We found no predictive factor for steroid-failure in first-line therapy. Older age (p = 0.003), presence of vertigo (p = 0.006) and more profound initial hearing loss (p < 0.001) were identified as negative prognostic markers.ConclusionRheopheresis can be used as a potentially effective and safe salvage therapy for patients with cortico-refractory SISHL.

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“…GPX3 polymorphisms have been associated with cardiovascular risk in a Mexican population [20]. A previous study showed that MetS is an independent risk factor for SSNHL in Taiwan after adjusting for potential confounding factors (adjusted OR Z 3.54, p < 0.01) [21]. The T allele frequency for rs3828599 of GPX3 is significantly lower in hypertensive patients than in controls (35.6% vs. 40.8%, p Z 0.009) in the Han Chinese population in China [22].…”

Section: Discussionmentioning

confidence: 96%

Glutathione peroxidase 3 gene polymorphisms and the risk of sudden sensorineural hearing loss

Chien

Huang

Tai

et al. 2017

The Kaohsiung J of Med Scie

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The glutathione peroxidase 3 gene (GPX3) is reported to be a risk factor for arterial ischaemic stroke and cerebral venous thrombosis. GPX3 may be one of the aetiologies of sudden sensorineural hearing loss (SSNHL), which might be attributed to the genetic effect of GPX3 by influence reactive oxygen species (ROS). Unbalanced ROS have been associated with susceptibility to SSNHL. Therefore, we conducted a case-control study with 416 SSNHL cases and 255 controls. Five single nucleotide polymorphisms (SNPs) were selected. The genotypes were determined using TaqMan genotyping assays. Each SNP was tested using the Hardy-Weinberg equilibrium (HWE), and the genetic effects were evaluated using three inheritance models. All five SNPs were in HWE. As the result, the AG genotype of rs3805435 had an adjusted odds ratio (OR) of 0.54 (95% confidence interval = 0.37-0.79, p = 0.001) compared with the AA genotype in the SSNHL cases. The GG and AG genotypes of the SNP rs3805435 were associated with SSNHL under the dominant model (p = 0.002, OR = 0.58). In conclusion, these results suggest that GPX3 polymorphisms influence susceptibility to SSNHL in southern Taiwan.

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Metabolic Syndrome Increases the Risk of Sudden Sensorineural Hearing Loss in Taiwan

Abstract: These results suggest that metabolic syndrome is an independent risk factor for sudden sensorineural hearing loss in Taiwan. Vertigo and total hearing loss were indicators of a poor outcome in sudden sensorineural hearing loss.

Cited by 54 publications

References 27 publications

Prognostic Factors in Sudden Sensorineural Hearing Loss

Prognostic Factors in Sudden Sensorineural Hearing Loss

Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss

Glutathione peroxidase 3 gene polymorphisms and the risk of sudden sensorineural hearing loss

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