title: Effect of comorbid diabetes and hypercholesterolemia on the prognosis of idiopathic sudden sensorineural hearing loss.
abstract: OBJECTIVE
  We tested the hypothesis that comorbid diseases significantly affect the prognosis of sudden sensorineural hearing loss (ISSNHL).
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  The records of patients newly diagnosed with ISSNHL and treated with steroid prednisolone in a tertiary referral center between January 2003 and December 2013 were retrospectively reviewed. Pretreatment and posttreatment hearing levels were evaluated using pure-tone average (PTA) and word recognition score (WRS). The comorbidities of diabetes, hypertension, coronary artery disease, hypercholesterolemia, cerebrovascular disease, chronic kidney disease, and anemia were identified. We examined the effects of these comorbid diseases on the prognosis of ISSNHL 2 months posttreatment.
  
  
  RESULTS
  Regression analyses adjusted for gender, age, pretreatment hearing, treatment delay time, and all the comorbidities showed that the probability of major improvement in the PTA was significantly higher in patients without diabetes compared to those with diabetes (univariate odds ratio [OR], 1.90; 95% confidence interval (CI), 1.25-2.90; multivariate OR, 1.69; 95% CI, 1.03-2.77). Major (≥ 90%) and moderate (50%-89% improvement of the PTA, but with a remaining hearing loss of > 10 dB) improvement in the PTA was significantly higher in patients without hypercholesterolemia compared to those with hypercholesterolemia (univariate OR, 1.78; 95% CI, 1.13-2.80; multivariate OR, 1.70; 95% CI, 1.02-2.84). There was, however, no significant difference in the distribution of major (≥ 90%), moderate (50%-89%), and minor (< 50%) improvement in the posttreatment WRS for these comorbid diseases.
  
  
  CONCLUSIONS
  Comorbid diabetes or hypercholesterolemia may indicate a smaller probability of major or moderate PTA improvement for patients with ISSNHL.
authors.affiliation: Department of Otolaryngology, Chi Mei Medical Center, Yongkang District, Tainan City.
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Lin
authors.affiliation: Department of Otolaryngology, Chi Mei Medical Center, Yongkang District, Tainan City.
authors.forename: Kuan-Ji
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, Chi Mei Medical Center, Yongkang District, Tainan City.
authors.forename: Shiou-Shyan
authors.initials: SS
authors.lastname: Yu
authors.affiliation: Department of Otolaryngology, Chi Mei Medical Center, Yongkang District, Tainan City.|Center of General Education, Southern Taiwan University of Science and Technology, Tainan.|Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yung-Song
authors.initials: YS
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002648:Child; D015897:Comorbidity; D048909:Diabetes Complications / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D003639:Hearing Loss, Sudden / Q000209:etiology*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone
keywords: Idiopathic sudden sensorineural hearing loss; anemia; chronic kidney disease; coronary artery disease; diabetes; hypercholesterolemia; hypertension