Diabetology & Metabolic Syndrome (Nov 2018)

Cochlear dysfunction and microvascular complications in patients with type 1 diabetes mellitus

  • João Soares Felício,
  • Lilian de Souza d’Albuquerque Silva,
  • Carlliane Lima e Lins Pinto Martins,
  • João Felício Abrahão Neto,
  • Manuela Nascimento de Lemos,
  • Fabrício de Souza Resende,
  • Wanderson Maia da Silva,
  • Angélica Leite de Alcântara,
  • Maria Clara Neres Iunes de Oliveira,
  • Norberto Jorge Kzan de Souza Neto,
  • Isabela Imbelloni Farias de Franco,
  • Nathalie Abdallah Zahalan,
  • Luísa Correa Janaú,
  • Ana Carolina Contente Braga de Souza,
  • Flavia Marques Santos,
  • Natércia Neves Marques de Queiroz,
  • Neyla Arroyo Lara Mourão,
  • Márcia Costa dos Santos,
  • Karem Miléo Felício,
  • Franciane Trindade Cunha de Melo

DOI
https://doi.org/10.1186/s13098-018-0380-z
Journal volume & issue
Vol. 10, no. 1
pp. 1 – 9

Abstract

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Abstract Sensorineural hearing impairment has been associated with DM, and it is probably linked to the same pathophysiological mechanisms as well-established in microvascular diabetes complications. The study of otoacoustic emissions (OAEs) is useful to identify subclinical cochlear dysfunction. Therefore, the aim of this study was to evaluate the association between abnormal OAEs responses, diabetic kidney disease (DKD) and diabetic cardiac autonomic neuropathy (CAN). We performed a cross-sectional study with 37 type 1 DM patients without auditory symptoms, submitted to the study of Distortion Product Otoacoustic Emissions (DPOAEs) and screened for DKD and CAN. The otoacoustic emissions responses were considered abnormal in 27/37 (73%) patients. A correlation was found between abnormal OAEs responses and presence of DKD (r = 0.36, p < 0.05), and 14/16 (88%) patients with a lower amplitude of OAEs in 8 kHz frequency band presented DKD. Abnormal OAEs responses in the 6 kHz frequency band were correlated with the presence (r = 0.41, p = 0.01) and severity of CAN (r = 0.44, p < 0.001). Additionally, 7/9 (78%) patients with abnormal OAE responses in this frequency also presented abnormal CAN scores. Our results suggest that abnormal otoacoustic emissions responses in high frequency bands are associated with diabetes microvascular complications and could be a risk marker for DKD and CAN, presenting low sensitivity and high specificity. Therefore, assuming that hearing impairment is a pre-clinical stage of hearing loss, performing distortion product otoacoustic emissions in T1DM patients with microvascular complications could be useful to identify those who would be benefit with regular audiologic follow up and tighter diabetes control.

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