Interaction between diabetes mellitus and hypertension on risk of hearing loss in highly endogamous population.

Aim: The aim of this study was to determine the prevalence of hearing loss and its association with type 2 diabetes mellitus (T2DM) in a highly endogamous population.

Design: This is a cross-sectional study.

Setting: The present study is carried out in Ear Nose Throat (ENT) and Endocrinology outpatient clinics of the Hamad General and Rumeilah Hospitals, Hamad Medical Corporation.

Subjects: All subjects aged between 20 and 59 years who visited the Endocrinology and ENT outpatient clinics of the Hamad Medical Corporation with hearing difficulty were included in this study during the period from January 2013 to July 2014.

Method: During the study period, prevalence, hearing, audiological test, family history and medical problems associated with hearing impairment in middle aged patients were recorded. Two audiometers Grason Stadler GSI 61 and Madsen Orbiter 922 were used to evaluate the hearing loss.

Result: Majority of the hearing loss observed at the age above 45 years old, (44.8% vs 51.7%, p=0.05). The prevalence of hearing impairment was higher in Qataris than in non-Qataris (59.7% vs 46.6%, p<0.001). The consanguineous marriages were observed higher in Hearing loss (32.1%) than in normal hearing (21.8%) (p=0.028). The mean of diabetes onset duration (7.8±4.12years), sleeping disorder (5.81±1.29h), obese subjects (38% vs 27.4%); family history of diabetes (30.6 vs 23.1%) were higher among hearing impairment. The associated risk factors were significantly higher in T2DM with hearing loss, hypoglycemia (32.8% vs 27.4%), retinopathy (313% vs 18.5%), Nephropathy (17.9% vs 9.8%), Neuropathy (17.9% vs 10.2%), macro-vascular disease (11.9% vs 6.2%), diabetic foot ulcer (20.9% vs 12.6%), Tinnitus (68.7% vs 51.3%), and Vertigo (25.4% vs 16.9%) than in normal hearing diabetes. There was a statistically significant differences between hearing impairment and normal hearing among T2DM regarding hearing assessment frequency (p=0.041). There were statistically significant differences between hearing impairment versus normal hearing for vitamin D [18.91±7.65ng/mL vs 22.85±9.00ng/mL; p<0.001], calcium [1.80±0.12ng/mL vs 1.96±0.14mmol/L; p<0.001], magnesium [0.80±0.09mmol/L vs 0.8±0.14mmol/L; p<0.001], phosphorous [1.42±0.30mmol/L vs 1.56±0.26mmol/L; p<0.001], ceatinine [1.42±0.30mmol/L vs 1.56±0.26mmol/L; p<0.001], cholesterol [4.92±1.08mmol/L vs 4.40±1.01mmol/L; p=0.035], LDL [1.92±0.88mmol/L vs 2.09±0.92mmol/L; p=0.024], albumin [43.1±6.10mmol/L vs 39.8±7.93mmol/L; p=0.010], systolic blood pressure [135.8±16.6Hg vs 130.2±12.5Hg; p=0.017] and, diastolic blood pressure [85.1±9.2mmHg vs 83.0±7.9mmHg; p=0.012]. There were highly statistically significant differences between hearing impairment versus normal for both side right and left ear frequency in Db unit (p<0.001). The multivariate stepwise logistic regression analysis revealed that head ache (p<0.001), family history of DM (p<0.001), sleep disturbance (p<0.001), high blood pressure (p=0.006), consanguinity (p=0.010), nationality (p=0.014), age in years (p=0.025), and sheesha smokers (p=0.045) were considered at higher risk as a predictors of hearing loss among diabetic patients.

Conclusion: The current study results confirm previous reports that adults with DM and hypertension associated showed greater hearing impairment in highly endogamous population… Diabetic patients with hearing loss were likely to have high blood glucose and other risk factors like hypertension, retinopathy, nephropathy and neuropathy.