阿司匹林与2型糖尿病患者突发性感音神经性听力损失风险的剂量-反应关系

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research Pub Date : 2025-02-07 DOI:10.1016/j.heares.2025.109217

Chih Chiang Liu , Wan-Ming Chen , Ben-Chang Shia , Szu-Yuan Wu , Wen-Jung Chou

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引用次数: 0

摘要

背景：突发性感音神经性听力损失（SSNHL）每年影响每10万人中5至27人，通常导致永久性听力损失和生活质量下降。2型糖尿病（T2D）可能通过血管损伤增加SSNHL的风险。阿司匹林用于T2D的心血管保护，但其对SSNHL的影响尚不确定，可能因剂量而异。根据累积阿司匹林暴露（cDDD≥28 vs. <28）对符合条件的T2D患者进行分类，并根据关键协变量进行匹配。Cox比例风险模型和Fine and Gray竞争风险模型评估了累积阿司匹林剂量四分位数的SSNHL和全因死亡率。结果在51,657对匹配组中，阿司匹林使用者和非使用者的SSNHL发病率相似，但出现了剂量-反应效应：cDDD最高四分位数（Q4）的患者SSNHL风险显著降低(调整后HR 0.43, 95% CI 0.32-0.58；p & lt;0.0001)，而较低的四分位数表明风险增加。阿司匹林的使用与全因死亡率降低相关（调整后HR 0.77, 95% CI, 0.75-0.80）。Fine和Gray的竞争风险模型证实，这种死亡率的降低并没有影响阿司匹林对SSNHL的剂量依赖性保护作用。即使在考虑竞争死亡风险后，阿司匹林与SSNHL的保护关联在最高四分位数中仍然显著(Q4, aHR 0.46, 95% CI, 0.34-0.62；p & lt;0.0001)，表明有独立的保护作用。结论：我们的研究结果表明，高累积剂量阿司匹林可降低T2D患者SSNHL的风险，这是一种剂量依赖关系，强调了适当剂量对潜在保护作用的重要性。需要进一步的研究来阐明这种剂量-反应关系。

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Dose-response relationship of aspirin and sudden sensorineural hearing loss risk in type 2 diabetes

Background

Sudden sensorineural hearing loss (SSNHL) affects 5 to 27 per 100,000 annually, often leading to permanent hearing loss and reduced quality of life. Type 2 diabetes (T2D) may heighten SSNHL risk via vascular damage. Aspirin is used in T2D for cardiovascular protection, yet its effect on SSNHL is uncertain and may vary by dose.

Methods

We conducted a cohort study using Taiwan's National Health Insurance Research Database to assess SSNHL risk associated with aspirin use in T2D patients. Eligible T2D patients were categorized based on cumulative aspirin exposure (cDDD ≥ 28 vs. <28) and matched on key covariates. Cox proportional hazards models and Fine and Gray's competing risk model assessed SSNHL and all-cause mortality across quartiles of cumulative aspirin dose.

Results

Among 51,657 matched pairs, SSNHL incidence was similar between aspirin users and non-users, but a dose-response effect emerged: patients in the highest cDDD quartile (Q4) had a significantly reduced SSNHL risk (adjusted HR 0.43, 95 % CI, 0.32–0.58; p < 0.0001), while lower quartiles showed increased risks. Aspirin use was associated with reduced all-cause mortality (adjusted HR 0.77, 95 % CI, 0.75–0.80). Fine and Gray's competing risk model confirmed that this reduction in mortality did not bias the observed dose-dependent protective effect of aspirin on SSNHL. Even after accounting for competing mortality risk, aspirin's protective association with SSNHL remained significant in the highest quartile (Q4, aHR 0.46, 95 % CI, 0.34–0.62; p < 0.0001), indicating an independent protective effect.

Conclusions

Our findings suggest a dose-dependent relationship where high cumulative doses of aspirin reduce SSNHL risk in T2D patients, underscoring the importance of adequate dosing for potential protective effects. Further research is necessary to clarify this dose-response relationship.

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来源期刊

Hearing Research 医学-耳鼻喉科学

CiteScore

5.30

自引率

14.30%

发文量

163

审稿时长

75 days

期刊介绍： The aim of the journal is to provide a forum for papers concerned with basic peripheral and central auditory mechanisms. Emphasis is on experimental and clinical studies, but theoretical and methodological papers will also be considered. The journal publishes original research papers, review and mini- review articles, rapid communications, method/protocol and perspective articles. Papers submitted should deal with auditory anatomy, physiology, psychophysics, imaging, modeling and behavioural studies in animals and humans, as well as hearing aids and cochlear implants. Papers dealing with the vestibular system are also considered for publication. Papers on comparative aspects of hearing and on effects of drugs and environmental contaminants on hearing function will also be considered. Clinical papers will be accepted when they contribute to the understanding of normal and pathological hearing functions.