Abstract
Hearing impairment (HI) and type 2 diabetes are both highly prevalent disabling conditions. Type 2 diabetes has been modestly associated with a higher likelihood of HI in many, but not all, population-based studies, with stronger associations found in studies that included younger age groups. Pathophysiologic studies suggest that persons with diabetes are predisposed to HI in the higher frequencies. Proposed mechanisms underlying the association between diabetes and HI include the combined contributions of hyperglycemia and oxidative stress to cochlear microangiopathy and auditory neuropathy. In this review, we highlight recent population-based studies of type 2 diabetes and HI and examine evidence for diabetes-induced pathophysiologic changes that may result in damage to the auditory system.
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Abbreviations
- PTA:
-
Pure-tone average
- HI:
-
Hearing impairment
- kHz:
-
Kilohertz
- dB:
-
Decibels, expressed as hearing level
- ABR:
-
Auditory brainstem response
References
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Agrawal Y, Platz EA, Niparko JK. Prevalence of hearing loss and differences by demographic characteristics among US adults: data from the National Health and Nutrition Examination Survey, 1999–2004. Arch Intern Med. 2008;168(14):1522–30. doi:10.1001/archinte.168.14.1522.
Lin FR, Niparko JK, Ferrucci L. Hearing loss prevalence in the United States. Arch Intern Med. 2011;171(20):1851–2. doi:10.1001/archinternmed.2011.506.
Contrera KJ, Betz J, Genther DJ, Lin FR. Association of Hearing Impairment and Mortality in the National Health and Nutrition Examination Survey. JAMA Otolaryngol Head Neck Surg. 2015;141(10):944–46. doi:10.1001/jamaoto.2015.1762.
Helzner EP. Age related hearing loss. In: Newman AB, Cauley JA, editors. The epidemiology of aging. Dordrecht: Springer; 2012.
Horikawa C, Kodama S, Tanaka S, Fujihara K, Hirasawa R, Yachi Y, et al. Diabetes and risk of hearing impairment in adults: a meta-analysis. J Clin Endocrinol Metab. 2013;98(1):51–8. doi:10.1210/jc.2012-2119. Meta-analysis of thirteen studies, pooling the data of 20,194 individuals, 7,377 of whom had HI based on a pure-tone audiometry. Compared to non-diabetic patients, the odds of HI among diabetic patients were 2.15 (95% CI 1.72–2.68). The association was stronger among adults <60 years compared to those ≥60 years.
Prevention CfDCa. National diabetes statistics report: estimates of diabetes and its burden in the United States. Atlanta: U.S. Department of Health and Human Services; 2014.
Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–14. doi:10.1001/jama.2014.732.
National Diabetes Data Group NIoDaDaKD. Diabetes in America. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995.
Fukushima H, Cureoglu S, Schachern PA, Paparella MM, Harada T, Oktay MF. Effects of type 2 diabetes mellitus on cochlear structure in humans. Arch Otolaryngol Head Neck Surg. 2006;132(9):934–8. doi:10.1001/archotol.132.9.934. This study of temporal bones from 18 type 2 diabetic patients and 26 age-matched controls found that, compared to controls, diabetic patients demonstrated greater reduction in cochlear hair cells, and thicker vessel walls and greater atrophy of the stria vascularis.
Helzner EP, Cauley JA, Pratt SR, Wisniewski SR, Zmuda JM, Talbott EO, et al. Race and sex differences in age-related hearing loss: the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2005;53(12):2119–27. doi:10.1111/j.1532-5415.2005.00525.x.
Bainbridge KE, Hoffman HJ, Cowie CC. Diabetes and hearing impairment in the United States: audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med. 2008;149:1–10.
Dalton DS, Cruickshanks KJ, Klein R, Klein BE, Wiley TL. Association of NIDDM and hearing loss. Diabetes Care. 1998;21(9):1540–4.
Mitchell P, Gopinath B, McMahon CM, Rochtchina E, Wang JJ, Boyages SC, et al. Relationship of Type 2 diabetes to the prevalence, incidence and progression of age-related hearing loss. Diabet Med. 2009;26(5):483–8. doi:10.1111/j.1464-5491.2009.02710.x.
Gates GA, Cobb JL, D’Agostino RB, Wolf PA. The relation of hearing in the elderly to the presence of cardiovascular disease and cardiovascular risk factors. Arch Otolaryngol Head Neck Surg. 1993;119(2):156–61. doi:10.1001/archotol.1993.01880140038006.
Lin FR, Thorpe R, Gordon-Salant S, Ferrucci L. Hearing loss prevalence and risk factors among older adults in the United States. J Gerontol Ser A Biol Med Sci. 2011;66(5):582–90. doi:10.1093/gerona/glr002.
Cheng YJ, Gregg EW, Saaddine JB, Imperatore G, Zhang X, Albright AL. Three decade change in the prevalence of hearing impairment and its association with diabetes in the United States. Prev Med. 2009;49(5):360–4.
Zipf G, Chiaapa M, Porter K, Ostchega Y, Lewis B, Dostal J. The National Health and Nutrition Examination Survey: Plan and Operations, 1999–2010. Vital Health Stat. 2013;1(56): National Center for Health Statistics.
Akinpelu OV, Mujica-Mota M, Daniel SJ. Is type 2 diabetes mellitus associated with alterations in hearing? A systematic review and meta-analysis. Laryngoscope. 2014;124(3):767–76. doi:10.1002/lary.24354. Meta-analysis of six studies (pooled sample of 900 type 2 diabetic patients and 5323 non-diabetic controls). Diabetic patients had 91% higher odds of HI than non-diabetic controls (OR 1.91, 95% CI 1.47–2.49). The association was stronger among adults <65 years compared to those ≥65 years.
Szalat A, Raz I. Metabolic syndrome and microangiopathy. Isr Med Assoc J. 2006;8(6):424–5.
Guerci B, Kearney-Schwartz A, Bohme P, Zannad F, Drouin P. Endothelial dysfunction and type 2 diabetes. Part 1: physiology and methods for exploring the endothelial function. Diabetes Metab. 2001;27(4 Pt 1):425–34.
Taslipinar A, Yaman H, Yilmaz MI, Demirbas S, Saglam M, Taslipinar MY, et al. The relationship between inflammation, endothelial dysfunction and proteinuria in patients with diabetic nephropathy. Scand J Clin Lab Invest. 2011;71(7):606–12. doi:10.3109/00365513.2011.598944.
Falbe-Hansen J. Histochemical studies on glycogen in the cochlea of drug-injected guinea pigs and alloxan-diabetic white rats. Acta Oto-Laryngologica Suppl. 1964; 57, Iss.sup188.
Nakae S, Tachibana M. The cochlea of the spontaneously diabetic mouse. II. Electron microscopic observations of non-obese diabetic mice. Arch Otorhinolaryngol. 1986;243(5):313–6.
Raynor E, Robison WG, Garrett CG, McGuirt WT, Pillsbury HC, Prazma J. Consumption of a high-galactose diet induces diabetic-like changes in the inner ear. Otolaryngol Head Neck Surg. 1995;113(6):748–54.
Makishima K, Tanaka K. Pathological changes of the inner ear and central auditory pathway in diabetic patients. Ann Otol Rhinol Laryngol. 1971;80(2):218–28.
Sonneville R, den Hertog HM, Guiza F, Gunst J, Derese I, Wouters PJ, et al. Impact of hyperglycemia on neuropathological alterations during critical illness. J Clin Endocrinol Metab. 2012;97(6):2113–23. doi:10.1210/jc.2011-2971.
Malone JI, Hanna S, Saporta S, Mervis RF, Park CR, Chong L, et al. Hyperglycemia not hypoglycemia alters neuronal dendrites and impairs spatial memory. Pediatr Diabetes. 2008;9(6):531–9. doi:10.1111/j.1399-5448.2008.00431.x.
Hinder LM, Vincent AM, Burant CF, Pennathur S, Feldman EL. Bioenergetics in diabetic neuropathy: what we need to know. J Peripher Nerv Syst. 2012;17 Suppl 2:10–4. doi:10.1111/j.1529-8027.2012.00389.x.
Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001;414(6865):813–20. doi:10.1038/414813a.
Vincent AM, Olzmann JA, Brownlee M, Sivitz WI, Russell JW. Uncoupling proteins prevent glucose-induced neuronal oxidative stress and programmed cell death. Diabetes. 2004;53(3):726–34.
Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgrad Med J. 2006;82(964):95–100. doi:10.1136/pgmj.2005.036137.
Kavanagh KT, Beardsley JV. Brain stem auditory evoked response. Ann Otol Rhinol Laryngol Suppl. 1979;88(4 Pt 2 Suppl 58):1–28.
Burkard RF, Eggermont JJ, Don M. Auditory evoked potentials: basic principles and clinical application. Philadelphia: Lippincott Williams & Wilkins; 2007.
Vaughan N, James K, McDermott D, Griest S, Fausti S. Auditory brainstem response differences in diabetic and non-diabetic veterans. J Am Acad Audiol. 2007;18(10):863–71.
Ernfors P, Van De Water T, Loring J, Jaenisch R. Complementary roles of BDNF and NT-3 in vestibular and auditory development. Neuron. 1995;14(6):1153–64.
Fritzsch B, Silos-Santiago I, Bianchi LM, Farinas I. The role of neurotrophic factors in regulating the development of inner ear innervation. Trends Neurosci. 1997;20(4):159–64.
Krabbe KS, Nielsen AR, Krogh-Madsen R, Plomgaard P, Rasmussen P, Erikstrup C, et al. Brain-derived neurotrophic factor (BDNF) and type 2 diabetes. Diabetologia. 2007;50(2):431–8. doi:10.1007/s00125-006-0537-4.
Huang TJ, Sayers NM, Verkhratsky A, Fernyhough P. Neurotrophin-3 prevents mitochondrial dysfunction in sensory neurons of streptozotocin-diabetic rats. Exp Neurol. 2005;194(1):279–83. doi:10.1016/j.expneurol.2005.03.001.
Jorgensen MB, Buch NH. Studies on inner-ear function and cranial nerves in diabetics. Acta Otolaryngol. 1961;53:350–64.
Gordon-Salant S. Hearing loss and aging: new research findings and clinical implications. J Rehabil Res Dev. 2005;42(4 Suppl 2):9–24.
Gratton MA, Schmiedt RA, Schulte BA. Age-related decreases in endocochlear potential are associated with vascular abnormalities in the stria vascularis. Hear Res. 1996;102(1–2):181–90.
Yamasoba T, Lin FR, Someya S, Kashio A, Sakamoto T, Kondo K. Current concepts in age-related hearing loss: epidemiology and mechanistic pathways. Hear Res. 2013;303:30–8. doi:10.1016/j.heares.2013.01.021.
Vasilyeva ON, Frisina ST, Zhu X, Walton JP, Frisina RD. Interactions of hearing loss and diabetes mellitus in the middle age CBA/CaJ mouse model of presbycusis. Hear Res. 2009;249(1–2):44–53. doi:10.1016/j.heares.2009.01.007.
Yamasoba T, Oka Y, Tsukuda K, Nakamura M, Kaga K. Auditory findings in patients with maternally inherited diabetes and deafness harboring a point mutation in the mitochondrial transfer RNA(Leu) (UUR) gene. Laryngoscope. 1996;106(1 Pt 1):49–53.
Arsenijevic D, Onuma H, Pecqueur C, Raimbault S, Manning BS, Miroux B, et al. Disruption of the uncoupling protein-2 gene in mice reveals a role in immunity and reactive oxygen species production. Nat Genet. 2000;26(4):435–9. doi:10.1038/82565.
Newkirk JE, Taylor RW, Howell N, Bindoff LA, Chinnery PF, Alberti KG, et al. Maternally inherited diabetes and deafness: prevalence in a hospital diabetic population. Diabet Med. 1997;14(6):457–60. doi:10.1002/(SICI)1096-9136(199706)14:6<457::AID-DIA372>3.0.CO;2-W.
Khardori R, Stephens JW, Page OC, Dow RS. Diabetes mellitus and optic atrophy in two siblings: a report on a new association and a review of the literature. Diabetes Care. 1983;6(1):67–70.
Eller P, Foger B, Gander R, Sauper T, Lechleitner M, Finkenstedt G, et al. Wolfram syndrome: a clinical and molecular genetic analysis. J Med Genet. 2001;38(11):E37.
Mayeda ER, Whitmer RA, Yaffe K. Diabetes and cognition. Clin Geriatr Med. 2015;31(1):101–15. doi:10.1016/j.cger.2014.08.021. ix.
Diabetes Public Health Resource. Health Status and Disability. Centers for Disease Control and Prevention web site. [http://www.cdc.gov/diabetes/statistics/health_status_national.htm]. Last updated October 5, 2012. Accessed 28 Oct 2015.
Diabetes Fast Stats. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/nchs/fastats/diabetes.htm Last updated September 29, 2015. Accessed 28 Oct 2015.
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Elizabeth Purchase Helzner and Kevin Contrera declare that they have no conflict of interest.
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Helzner, E.P., Contrera, K.J. Type 2 Diabetes and Hearing Impairment. Curr Diab Rep 16, 3 (2016). https://doi.org/10.1007/s11892-015-0696-0
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DOI: https://doi.org/10.1007/s11892-015-0696-0