The Effect of Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio on the Severity of Diabetes Mellitus Type II and Air and Bone Conduction Hearing Threshold at Speech Frequency

Abstract

Background: Diabetes Mellitus Type II (DMT II) is a metabolic disorder characterized by chronic hyperglycemia resulting from relative or absolute insulin deficiency. It can cause various complications, including hearing loss (HL). NLR and PLR can determine the severity of DMT II but are not yet known for HL. Methods: This research was quantitative, analytically observational, and cross-sectional, using medical record data from July-November 2022. The variables were age, NLR, PLR, FBG, the duration and severity of DMT II, the air and bone conduction thresholds at speech frequencies (500, 1000, 2000, and 4000 Hz). Results: 43 respondents (86 ears) met the inclusion and exclusion criteria. The mean age was 61.63 + 8.64 years, with more women (60.5%, 26/43) than men (39.5%, 17/43). The mean duration of DM was 10.45 + 8.77 years. The average severity level was 2.63 + 1.77, which means that respondents in this study had more than two complications on average. DM in the elderly > 60 years old has a risk of HL 9.839 times compared to those < 60. DM with a high NLR can increase the risk of HL by increasing the incidence of HL, bilateral sides, type and degree of HL, and air and bone conduction threshold. DM with NLR > 2.76 is more at risk of experiencing HL as much as 6.83 times compared to DM with NLR < 2.76. Factors that predict HL in DM are age, NLR, and FBG, which are 33.1%, while other factors determine 66.7%. The age, FBG, and NLR variables can predict hearing loss in DM with moderate accuracy (AUC 76.7%). Conclusion: Hearing loss needs to be added to the screening program for complications of diabetes mellitus. A hearing screening program is needed for DM aged > 60 years, FGB > 126 mg/dl and NLR > 2,76. NLR could be used to predict hearing loss incidents in DMT II.