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Original Investigation
April 2018

Association of Metabolic Syndrome With Sudden Sensorineural Hearing Loss

Author Affiliations
  • 1Department of Otorhinolaryngology–Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
  • 2Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
JAMA Otolaryngol Head Neck Surg. 2018;144(4):308-314. doi:10.1001/jamaoto.2017.3144
Key Points

Question  Is metabolic syndrome associated with recovery from sudden sensorineural hearing loss?

Findings  In this medical record review of 124 patients with sudden sensorineural hearing loss, the rate of recovery was lower and the prognosis was poorer in patients with metabolic syndrome than in patients without metabolic syndrome and these measures were worse in patients with 4 or more factors of metabolic syndrome than in those with 3 factors.

Meaning  The presence of metabolic syndrome may be associated with impaired recovery from sudden sensorineural hearing loss.

Abstract

Importance  Each of the 5 diagnostic criteria or factors of metabolic syndrome—hyperglycemia or type 2 diabetes, hypertension, obesity, elevated triglyceride levels, and decreased high-density lipoprotein cholesterol level—is associated with the pathophysiologic features of sudden sensorineural hearing loss (SSNHL). Little is known, however, about the association of metabolic syndrome, defined as the presence of at least 3 of these factors, with the prognosis of SSNHL.

Objective  To evaluate the association of metabolic syndrome with the rate of recovery from SSNHL.

Design, Setting, and Participants  This retrospective medical record review of 124 patients treated for SSNHL at a single tertiary university hospital was performed from June 1, 2014, through May 31, 2016. Medical records were reviewed for demographic and clinical characteristics and audiologic variables.

Exposure  Sudden sensorineural hearing loss.

Main Outcomes and Measures  Correlation among demographic and clinical characteristics, audiologic results, and prognosis.

Results  Of the total 124 patients (52 men [41.9%]; 72 women [58.1%]; mean [SD] age, 56.0 [14.6] years), 70 had metabolic syndrome and 54 did not. Rates of type 2 diabetes (36 [51.4%] vs 6 [11.1%]; mean difference [MD], 40.3%; 95% CI, 24.4%-53.1%), hypertension (46 [65.7%] vs 9 [16.7%]; MD, 49.1%; 95% CI, 32.3%-61.7%), and obesity (47 [67.1%] vs 6 [11.1%]; MD%, 56.0; 95% CI, 40.0%-67.5%) and mean (SD) concentrations of triglycerides (192.9 [159.7] vs 133.4 [116.6] mg/dL; MD, 59.4 mg/dL; 95% CI, 53.0-65.9 mg/dL) were significantly higher and mean (SD) concentrations of high-density lipoprotein cholesterol (45.8 [9.4] vs 62.6 [17.7] mg/dL; MD, 16.8 mg/dL; 95% CI, 16.1-17.4 mg/dL) were significantly lower in the group with metabolic syndrome than in the group without metabolic syndrome. Mean (SD) pure-tone audiometry thresholds were similar at baseline in the groups with and without metabolic syndrome (65.0 [24.2] vs 60.8 [24.2] dB; MD, 4.3 dB; 95% CI, 3.2-5.4 dB), but recovery rates after treatment were significantly lower in the group with metabolic syndrome (16 [22.9%] vs 23 [42.6%]; MD, −19.7%; 95% CI, −35.4% to −3.2%). No differences were found in the 5 factors among patients with metabolic syndrome who did and did not recover. Level of hearing loss was higher in patients with than without metabolic syndrome, but the difference was not statistically significant. Audiogram patterns also differed but not significantly. Hearing recovery rates were similar in patients with 3 factors of metabolic syndrome and those with none but differed significantly between patients with 4 or more factors and those without metabolic syndrome (4 [19.0%] vs 27 [50.0%]; MD, −31.0%; 95% CI, −48.1% to −6.4%).

Conclusions and Relevance  The rate of recovery from SSNHL was lower among patients with metabolic syndrome than among those without metabolic syndrome, and prognosis was poorer in patients with 4 or more diagnostic factors of the metabolic syndrome.

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