Abstract
Type 1 diabetes can lead to impaired function of many organs and tissues. The aim of this study was to evaluate associations between hearing and kidney function in young adult type 1 diabetic patients. 31 patients (9 women) with type 1 diabetes, aged <45, with disease duration <10 years were included. Blood and urine samples for laboratory tests and urinary albumin excretion (UAE) assessment were obtained. eGFR was calculated with CKD-EPI formula. In all patients pure-tone audiometry, transient evoked otoacoustic emissions and auditory brainstem responses were evaluated, also eye fundus was examined. Mean patients’ age was 29.5 ± 7.0 years and disease duration 4.6 ± 2.6 years. All patients had eGFR > 60.0 ml/min/1.73 m2. In one case microalbuminuria and in 3 patients early retinopathy were revealed. Linear correlation between eGFR and hearing threshold at 4, 6, 8 and 12 kHz was found. Patients with hearing impairment (n = 7) had lower eGFR 108.8 vs. 121.7 ml/min/1.73 m2, p = 0.047 compared to normal-hearing subjects. Also patients with absence of otoacoustic emissions in at least one ear had lower eGFR, 103.1 vs. 123.3 ml/min/1.73 m2, p < 0.001, compared to the remaining group. In auditory brainstem responses we found significant linear correlation between eGFR and wave III and interval I-III latencies, and between UAE and waves III, V and interval I-III latencies. This study suggests existence of relationship between hearing and kidney function in type 1 diabetic patients. Pathways directly linking hearing and renal function are unknown. Larger studies are necessary to further analyze these relationships.
Highlights
Incidence of type 1 diabetes continues to rise
In 3 patients estimated glomerular filtration rate (eGFR) was between 75.0 and 90.0 mL/min/1.73 m2, the rest had eGFR above 90.0 mL/min/1.73 m2
Hearing impairment assessed in pure-tone audiometry (PTA) is significantly more prevalent among patients both with type 1 and type 2 diabetes, compared to non-diabetic population[4,16]
Summary
Incidence of type 1 diabetes continues to rise. In Podkarpackie Region in South-Eastern Poland, in population below it reached almost new cases per 100,000 children and adolescents in this age range in the year 2013 (Malesa and Dąbrowski, unpublished data). Dysfunction of hearing organ is significantly more frequent in type 1 diabetic patients, compared to non-diabetic population, which was summarized in a recently published meta-analysis[4]. Prevalence of ESRD in type 1 diabetes in Finland after 20 and 30 years of disease duration was 2.2% and 7.0% of patients respectively[9]. Higher ESRD was observed in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study with 5.5%, 14.5% and 26.5% affected after 20, 30 and 40 years of diabetes duration respectively[11]. The primary objective of our cross-sectional study, was to evaluate whether auditory organ function, assessed by PTA, OAEs and ABR correlates to kidney function in a group of relatively young adult type 1 diabetic subjects with a short duration of the disease. This study is a post-hoc analysis of our previously published data[5,14,15]
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