Abstract
ObjectivesOur objectives are to examine whether patients with fibromyalgia (FM) present an increased risk of hearing loss (HL) compared with those without FM and to explore the relationship between comorbidities/drugs and development of HL in patients with FM. Furthermore, we investigated the incidence rate of different types of HL and the joint effects for HL with FM and comorbidities.MethodsThis population-based retrospective cohort study included patients with new-onset FM from 2000 to 2002 (the FM group) and age- and sex-matched randomized patients without FM (the non-FM group) from Taiwan’s National Health Insurance Research Database. Patients were followed up from baseline (3 months after FM diagnosis) until death, withdrawal, HL development, or December 31, 2013. The primary outcome was the risk of HL, which was assessed using Cox proportional-hazards analysis.ResultsThe overall HL risk in the FM group was 1.46-fold (95% confidence interval [CI]: 1.38–1.55) higher than that in the non-FM group after adjustment for sex, age, and comorbidities (p < 0.0001). Patients with FM had significantly greater sensorineural HL (adjusted hazard ratio = 1.46, 95% CI: 1.37–1.56) than those without FM. Patients with FM having comorbidities of diabetes, hyperlipidemia, depression, and Meniere’s disease had a higher risk of HL than those without FM.ConclusionOur findings support the notion that FM influences HL and is in line with the hypothesis that the FM mechanism is related to a central nervous system abnormality in sensory processing. Health care professionals should provide appropriate screening for the risk of HL and prevention and counseling methods for patients with FM.
Highlights
Fibromyalgia (FM) is a musculoskeletal condition characterized by chronic widespread pain and specific tender points [1]
The overall hearing loss (HL) risk in the FM group was 1.46-fold (95% confidence interval [CI]: 1.38–1.55) higher than that in the non-FM group after adjustment for sex, age, and comorbidities (p < 0.0001)
Patients with FM had significantly greater sensorineural HL than those without FM
Summary
Fibromyalgia (FM) is a musculoskeletal condition characterized by chronic widespread pain and specific tender points [1]. Patients with FM often have nonspecific symptoms and are at increased risk of many comorbidities and disorders [4]. Central sensitization involves CNS pain amplification and neuroendocrine dysfunctions, including decreased levels of serotonin (which inhibits pain signals) and increased levels of substance P (which propagates pain signals) [7, 8], leading to abnormal pain processing [7]. Patients with FM might have brainstem dysfunction, which may cause abnormalities in processing auditory stimuli [5, 6]. Taken together, these findings imply that patients with FM have hypersensitivity toward pain and sensory processing such as hearing
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