No5(4) 2021
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DOI 10.37219/2528-8253-2021-5-47 |
Shydlovska TA, Shydlovska TV, Navalkivska NY
The level of peripheral myelin protein and vitamin D in blood serum among
patients suffering diabetes mellitus type II and hearing impairment |
Shidlovskaya Tetiana A.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Head of the laboratory of voice and hearing
Doctor of Medical Sciences, Professor
E-mail: lorprof3@ukr.net
Orchid ID: https://orcid.org/0000-0002-7894-359X
Shidlovskaya Tamara V.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Laboratory of Voice and Hearing
Doctor of Medical Sciences, Professor
E-mail: doctor_sh@ukr.net
Navalkivska Nadiya Ya.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Graduate student
E-mail: navalkivska.nadia@gmail.com |
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Abstract
Topicality: While diabetes mellitus is often observed hearing
impairment, including sensorineural hearing loss (SNHL). On the other hand,
metabolic changes, disorders of the hemostasis system, lack of vitamins and
minerals can lead to the development of SNHL.
Aim: to examine the level of peripheral myelin protein (PMP) and
vitamin D in patients with diabetes mellitus type II with hearing
impairment.
Materials and methods: Were examined 43 patients with diabetes
mellitus type II, who, according to subjective audiometry, revealed SNHL of
the I-II degree according to the International Classification. We divided
patients into two groups: group 1st
included 22 patients without complications, group 2nd – 21 patients with
complications of diabetes mellitus and sudden changes in blood sugar levels
in the anamnesis. As a comparison group were examined 15 patients with SNP
without high blood sugar. The control group consisted of 15 healthy
individuals.
Results and discussion: When analyzing the results of the study, it
was found that in patients with diabetes mellitus and SNHL (groups 1st and
2nd) there was a significant increase of the level of PMP comparing with the
control and the comparison group. Moreover, in group 2nd (with complicated
diabetes mellitus) the increase of the level of PMP in the blood serum was
reliably more significant than in group 1st. In patients with diabetes
mellitus group 1st the level of PMP was from 2.3 to 9.8 ng/ml (average value
of 7.2±0.5 ng/ml), in group 2 PMP had a level of 8.5 to 37.2 ng/ml (average
value of 24.3±1.7 ng/ml). This is significantly (P<0.01) more than in the
control group. Elevated levels of PMP in patients with diabetes mellitus may
indicate the processes of demyelination, damage of neural structures, which
are more pronounced in the complicated course of diabetes, which, obviously,
have some significance in the development of SNHL in diabetes mellitus type
II.
As for the content of vitamin D, certain reductions in its level were
observed in all groups of examined patients with SNHL. However, in patients
with SNHL without diabetes mellitus, this decrease was not differing
significantly from the control values. But in both groups of patients with
SNHL on the background of diabetes mellitus, this difference was
significant, especially in group 2nd. Decreasing the level of vitamin D in
blood serum, more expressed at the complicated course of diabetes mellitus
in patients with SNHL testifies of a certain role of this vitamin in
deepening of metabolic disturbances at such patients, and consequently –
faster and more expressed development of complications.
While the analysis of the distribution of patients with deviation of PMP
level and vitamin D, it was found that in groups of patients with diabetes,
especially in group 2nd with a complicated course, in blood serum there was
significantly more often than in the comparison group a lack of vitamin B
and increasing of PMP. Moreover, in group 2nd deviations from the norm in
the level of PMP were also significantly more often than in group 1st. In
the group of SNHL without diabetes mellitus (group 3rd) vitamin D deficiency
was observed only in 13.3% of cases. A deficiency of vitamin D in group 2nd
occurred significantly more often not only comparing with the control and
comparison group, but also relatively to group 1st, with a milder course of
diabetes. Thus, in group 2nd in patients with diabetes and SNHL, the lack of
vitamin D occurred in 26.6% and its deficiency – in 73.3% of cases.
In general, a decrease of vitamin D levels occurred in 100% of patients in
group 2nd and in 80% in group 1st, while in group 3rd
– 30%.
Thus, researches have shown that in all studied groups of patients with SNHL
on the background of diabetes mellitus type II there are deviations from the
norm in the content of PMP and vitamin D in the blood serum. Moreover, the
most pronounced disorders were found in the examined, who also had a
complicated course of diabetes mellitus type II, the episodes of
hypoglycemia in the anamnesis. This indicates the possible role of a
complicated course of diabetes mellitus type II on the development of
disorders (including demyelinating processes) in the neural structures of
the auditory analyzer.
Conclusions: In patients with diabetes mellitus type II and
sensorineural hearing loss there is a significant increase in the content of
PMP in blood serum, more pronounced in complicated diabetes, which may
indicate the processes of demyelination and damage of neural structures.
In patients with sensorineural hearing loss on the background of diabetes
mellitus type II there is a significant (P <0.01) reduced levels of vitamin
D compared with the control, the severity of reducing indicates its lack and
even deficiency, especially occurred on the background of complications of
diabetes mellitus.
Patients with diabetes mellitus type II with sensorineural hearing loss, who
have a complicated course, polyneuropathy, episodes of a severe changes of
sugar levels in anamnesis, there is a significant (P<0.05) more pronounced
increasing levels of PMP and decreasing of vitamin D than in patients with
milder course of disease.
The obtained data may indicate an important role of demyelinating processes
and vitamin D deficiency in the development of sensorineural hearing
impairment among patients with diabetes mellitus type 2. |
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Keywords
sensorineural hearing loss, diabetes mellitus, auditory analyzer,
peripheral myelin protein, vitamin D |
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