1.Relationship between hearing threshold and peripheral neuropathy in type 2 diabetic patients
Juan SHEN ; Fang LIU ; Hui ZENG ; Jie YU ; Qiag LI ; Yuqian BAO ; Weipiag JIA
Chinese Journal of Endocrinology and Metabolism 2011;27(8):644-648
Objective In order to investigate the relationship between hearing loss and diabetic peripheral neuropathy( DPN ) via comparing the pure tone thresholds and vibration perception threshold(VPT) in type 2 diabetic patients and control person without diabetes. Methods 173 subjects including 138 type 2 diabetic patients(DM)and 35 non-diabetes controls were examined for VPT and hearing threshold. Nerve conducting velocity ( NCV )including sensory nerve conducting velocity( SCV )and motorial nerve conducting velocity( MCV )of diabetic patients were determined. The participants were divided into three groups: control group (n = 35 ), DM group without peripheral neuropathy( non-PN group, n = 74 ), and DM group complicated with peripheral neuropathy (PN group,n = 64 ). The clinical characteristics, biochemical parameters , the incidence of sensorineural hearing loss ( SNHL),pure tone threshold, and VPT were compared among three groups. At last, the relationship between hearing thresholds and NCV were analyzed. Results The incidence of hearing impairment of sensorineural type was 29.69% in PN group, which was significantly higher than that of non-PN group( 17.57% )and control group( 17. 14% ). There was significant differences in age, duration of diabetes, glycolated hemoglobin (HbA1c), glycolated serum albumin ( GA), Fasting blood glucose( FPG), 2h postprandial blood glucose( PPG), VPT, and hearing threshold among the three groups( all P<0. 05 ). The value of hearing threshold increased significantly( all P<0. 05 ) in 3 VPT subgroups with VPT≤ 15 V, VPT 16-25 V, and VPT >25 V. The Spearman correlation analysis showed median NCV was negatively correlated with hearing threshold on 1.00, 2.00, 4. 00, and 8. 00 kHz ( All P < 0. 05 ). The logistic regression analysis indicated that the age( regression coefficient =0. 088, P<0. 01 ) was the independent risk factor of SNHL, median nerve MCV ( regression coefficient = -0. 135, P = 0. 046 ) was the important influencing factor of SNHL. Conclusion Diabetic patients are more likely to suffer from impaired middle-frequency and high-frequency hearing, DPN in patients is often complicated with hearing impairment. Age and median nerve MCV were major risk factors of SNHL in diabetic patients.
2.Impact of maternal subclinical hypothyroidism during the first trimester on brain development of the offspring: a prospective study
Haibo XUE ; Yuanbin LI ; Weipiag TENG ; Zhongyan SHAN ; Xiaohui YU ; Yushu LI ; Weiwei WANG ; Yanyan CHEN ; Jia LI ; Haixia GUAN ; Xiaochun TENG ; Jing LI ; Yun GAO ; Chenling FAN ; Hong WANG ; Hongmei ZHANG
Chinese Journal of Endocrinology and Metabolism 2010;26(11):916-920
Objective To assess the effects of maternal subclinical hypothyroidism (SCH) during the first trimester on neuropsychological development of the offspring by 20-30 months. Methods In this study, 1 761 pregnant women from 10 hospitals with about 8 weeks of gestation were enrolled. Urinary iodine excretion and serum thyrotropin ( TSH ), free thyroxine ( FT4 ), and thyroid peroxidase antibody ( TPOAb ) levels were determined in all subjects. Pregnant women with SCH (TSH≥2.5 mIU/L) were divided into two subgroups using trimester-specific thyroid function reference: group A (2.5 mIU/L≤TSH<3.93 mIU/L, 18 cases), and group B (TSH ≥3.93 mIU/L, 20 eases). Thirty euthyroid and TPOAb-negative women from the same cohort were selected as controls. Intellectual and motor development score evaluations were performed in the children by 20-30 months of age. Results Children of women with SCH and subgroups A and B had lower mean intelligence scores 6.55,3.39, and 9.40 points compared with those of the control group (P=0. 001, P=0. 125, and P<0. 001 ); the respective mean motor scores were 6.31,4.35, and 8.07 points being lower than that of the control ( P=0. 003,P=0. 070, and P=0. 001 ). Intelligence scores and motor scores were negatively correlated with TSH levels (r=-0.425, P<0. 001 and r=-0. 394, P=0. 001 ). Multiple group comparisons revealed that differences of TSH affected intelligence and motor scores (F=9. 277, P<0. 001 and F=5. 909, P=0. 004). Ordinal logistic regression analysis showed that possibilities for the reduction of filial mental development index ( MDI ) and psychomotor development index ( PDI ) scores in SCH with maternal TSH levels≥3.93 mIU/L were 8.66 and 6.27 times that of controls ( OR = 8.66,95% CI 2.72-27.57, OR =6.27,95% CI 2.03-19.34 ). Conclusion Maternal elevated TSH levels diagnosed by trimester-specific reference during early gestation are independently associated with lowered filial neurodevelopment scores by 20-30 months.