The effect of osteoporosis on cochlear function in postmenopausal women: An observational study

Yıl 2018, , 273 - 277, 01.09.2018

Saime Sağıroğlu , Tuba Tülay Koca

https://doi.org/10.28982/josam.429059

Öz

Aim: Hearing loss and osteoporosis are common geriatric syndromes. Evidence suggests that osteoporosis may have an effect on cochlear function in a small number of clinical trials. Here, cochlear function in osteoporosis patients was assessed by otoacoustic emission test measurements.

Methods: The study designed as cross-sectional and observational. Forty female patients were included in the postmenopausal period at the age of 40-75 years. Age, body mass index (BMI), vitamin D level were recorded in all patients. Audiometric threshold testing was used to measure air- and bone-conduction hearing sensitivity. Bone mineral density (BMD) of the hip and vertebra was measured using dual-energy X-ray absorptiometry (DEXA). According to vertebra L1-4 t score <-2.5 osteoporosis, -2.5 to -1 osteopenic, the group divided into two and all parameters were compared. Transiently evoked (TE), and distortion-product (DP) otoacoustic emissions were recorded.

Results: The mean age of the whole group was 58.6 ± 7.9 years. Accordingly, TE left was significantly different in the higher frequency in the osteopenic group at 0.75 Hz (p = 0.015). In audiometric tests, only the osteopenic group at 6,000 dB was significantly different in the higher frequency of both ears (p = 0.049 / p = 0.016).

When the group divided into two according to femur t score <-1.0; TEright_3.5 (p = 0,04), TEright_overall (p = 0,030), TEleft_1.7.5 (p = 0,043) and TEleft_overall (p = p = 0.046), DPright_1 (p = 0.049) and DPleft_6 (p = 0.039) were observed to occur at higher frequencies in the osteoporotic group. Lomber t score was positively correlated with BMI (p = 0.042 / r = 0.288). BMI was lower in the osteoporotic group. The tympanogram results of all patients were Type A. The TE positivity rate (S / N> 3) was 60.8% and the DP positivity rate (S / N> 3) was 39.2%.

Conclusion: According to hip BMD scores, osteopenic-osteoporotic (T scor <-1) group showed higher frequencies in both cochlear and hearing tests than normal subjects. The high frequencies in both OAET results and odiologic data in osteoporotic group support the adverse effect of osteoporosis on cochlear and hearing function. Individuals with hearing loss should be screened for osteoporosis.

Anahtar Kelimeler

Bone mineral density, Osteoporosis, Hearing loss, Cochlear function

Postmenapozal kadınlarda koklear fonksiyona osteoporozun etkisi: Gözlemsel bir çalışma

Öz

Amaç: İşitme kaybı ve osteoporoz sık görülen geriatrik sendromlardandır. Az sayıda klinik çalışmada osteoporozun koklear fonksiyona etkisi olabileceği yönünde delil bulunmuştur. Burada osteoporoz hastalarında kohlear fonksiyon, otoaküstik emisyon test (OAET) ölçümleri ile değerlendirildi. 

Yöntemler: Çalışma kesitsel gözlemsel olarak diüzenlendi. Çalışmaya 40-75 yaş aralığında postmenapozal dönemde 50 kadın hasta dahil edildi. Tüm hastalarda yaş, vücut kitle indeksi (BMI), vitamin D düzeyi kayıt edildi. Hava ve kemik iletimli işitme hassasiyetini ölçmek için odiyometrik eşik testi kullanıldı. Kalça ve omurganın kemik mineral yoğunluğu (BMD) dual enerji X-ışını absorpsiyometri (DEXA) kullanılarak ölçüldü. Vertebra L1-4 t skor<-2,5 osteoporoz, -2,5 ila -1 arası osteopenik olarak grup ikiye ayrıldı ve tüm parametreler karşılaştırıldı. Geçici olarak uyarılmış (TE) ve distorsiyon ürünü (DP) otoakustik emisyonları kaydedildi.

Bulgular: Tüm grup yaş ortalaması 58,6±7,9 yıl idi. Buna göre TE left 0.75 Hz’de osteopenik grupta daha yüksek frekansda anlamlı farklı idi (p=0,015). İşitme testlerinde sadece her iki kulak 6.000 db’de osteopenik grup daha yüksek frekansda anlamlı farklı idi (p=0,049 / p=0,016).

Femur t skor<-1,0 göre grup ikiye ayrıldığında TEright_2.5 (p=0,015), TEright_3.5 (p=0,04), TEright_overall (p=0,030), TEleft_1.7.5 (p=0,043), TEleft_overall (p=0,046), DPright_1 (p=0.049), DPleft_6 (p=0,039) osteoporotik grupta daha yüksek frekanslarda sonuçlar olduğu gözlendi. Lomber t skor BMI ile pozitif korele (p=0,042/r=0,288) idi. Osteoporotik grubda BMI daha düşük idi. Hastaların tamamında timpanogram sonuçları Tip A idi. TE pozitiflik oranı (S/N>3) %60,8, DP pozitiflik oranı (S/N>3) %39,2 idi. 

Sonuç: Kalça BMD skorlarına göre, osteopenik_osteoporotik grup (T skor<-1) hem koklear hem da işitme testlerinde normal kişilere göre yüksek frekanslar gösterdiler. Osteoporotik grupta hem OAET sonuçları hemde odiyolojik verilerin daha yüksek frekanslarda olması osteoporozun koklear ve işitme fonksiyonuna olumsuz etkisini desteklemektedir.  İşitme kaybı olan bireyler osteoporoz yönünden taranmalıdır.

Anahtar Kelimeler

Kemik mineral yoğunluğu, Osteoporoz, İşitme kaybı, Koklear fonksiyon

Kaynakça

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