title: Hyperinsulinemia and hyperglycemia: risk factors for recurrence of benign paroxysmal positional vertigo.
abstract: BACKGROUND
  Changes in carbohydrate metabolism may lead to recurrence of benign paroxysmal positional vertigo.
  
  
  OBJECTIVE
  To evaluate the influence of the disturbance of carbohydrate metabolism in the recurrence of idiopathic BPPV.
  
  
  METHODS
  A longitudinal prospective study of a cohort, with 41 months follow-up. We analyzed the results of 72 glucose-insulin curves in patients with recurrence of BPPV. The curves were classified into intolerance, hyperinsulinemia, hyperglycemia and normal.
  
  
  RESULTS
  The RR for hyperinsulinism was 4.66 and p=0.0015. Existing hyperglycemia showed an RR=2.47, with p=0.0123. Glucose intolerance had a RR of 0.63, with p=0.096. When the examination was within normal limits, the result was RR=0.2225 and p=0.030.
  
  
  CONCLUSIONS
  Metabolic changes can cause dizziness and vertigo and are very common in people who have cochleovestibular disorders. However, few studies discuss the relationship between idiopathic BPPV and alterations in carbohydrate metabolism. In the present study, we found that both hyperglycemia and hyperinsulinemia are risk factors for the recurrence of BPPV, whereas a normal test was considered a protective factor; all these were statistically significant. Glucose intolerance that was already present was not statistically significant in the group evaluated.
  
  
  CONCLUSIONS
  Hyperinsulinemia and hyperglycemia are risk factors for the recurrence of idiopathic BPPV and a normal exam is considered a protective factor.
authors.affiliation: Hospital do Servidor Público Municipal de São Paulo (HSPM), São Paulo, SP, Brazil. Electronic address: guilhermewebster@uol.com.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Webster
authors.affiliation: Hospital do Servidor Público Municipal de São Paulo (HSPM), São Paulo, SP, Brazil.
authors.forename: Patrícia Maria
authors.initials: PM
authors.lastname: Sens
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brazil.
authors.forename: Márcio Cavalcante
authors.initials: MC
authors.lastname: Salmito
authors.affiliation: Hospital do Servidor Público Municipal de São Paulo (HSPM), São Paulo, SP, Brazil.
authors.forename: José Diogo Rijo
authors.initials: JD
authors.lastname: Cavalcante
authors.affiliation: Hospital do Servidor Público Municipal de São Paulo (HSPM), São Paulo, SP, Brazil.
authors.forename: Paula Regina Bonifácio dos
authors.initials: PR
authors.lastname: Santos
authors.affiliation: Hospital do Servidor Público Municipal de São Paulo (HSPM), São Paulo, SP, Brazil.
authors.forename: Ana Lívia Muniz da
authors.initials: AL
authors.lastname: Silva
authors.affiliation: Hospital do Servidor Público Municipal de São Paulo (HSPM), São Paulo, SP, Brazil.
authors.forename: Érica Carla Figueiredo de
authors.initials: ÉC
authors.lastname: Souza
mesh_terms: D065635:Benign Paroxysmal Positional Vertigo / Q000209:etiology*; D038321:Glycemic Index; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000175:diagnosis; D006946:Hyperinsulinism / Q000150:complications* / Q000175:diagnosis; D008137:Longitudinal Studies; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
keywords: Carbohydrate metabolism; Dizziness; Glucose metabolism disorders; Metabolismo dos carboidratos; Tontura; Transtornos do metabolismo de glucose; Vertigem; Vertigo