title: Early detection of hearing impairment in patients with diabetes mellitus with otoacoustic emission. A systematic review and meta-analysis.
abstract: CONCLUSIONS
  The distortion product otoacoustic emission (DPOAE) amplitudes in diabetics were significantly lower than those in controls when pure tone audiometry (PTA) was within normal limits, implying cochlear function impairment in the early stage of diabetes mellitus. Retrocochlear damage was suggested by elongated wave latencies and the wave interval of auditory brainstem response (ABR) in diabetics.
  
  
  OBJECTIVE
  This study aimed to systematically analyze the application of DPOAE in evaluation of the hearing function of diabetics.
  
  
  METHODS
  Eligible articles were identified through searches of nine different electronic databases. Two investigators reviewed the original articles independently, with pre-defined inclusion and exclusion criteria. Meta-analyses were conducted by using Metan module.
  
  
  RESULTS
  There were seven articles eligible for the analysis. PTA thresholds were within normal limits in all diabetics at low-middle frequencies. The mean DPOAE amplitudes of diabetics were significantly lower than those of controls. The standardized mean difference (SMD) (95% CI) was -0.49 (-0.70, -0.27), -0.46 (-0.63, -0.30), and -0.60 (-0.77, -0.43) at 1, 2, and 4 kHz, respectively. The latencies of waves I, III, and V in diabetes were significantly longer than those of controls (0.43 (0.23, 0.64), 0.54 (0.33, 0.75), and 0.56 (0.35, 0.77), respectively). The wave interval I-V was significantly longer in diabetics (p < .001, 0.47 [0.24, 0.70]).
authors.affiliation: a Department of Otolaryngology, Head and Neck Surgery , Beijing Tongren Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Jin
authors.initials: J
authors.lastname: Hao
authors.affiliation: a Department of Otolaryngology, Head and Neck Surgery , Beijing Tongren Hospital, Capital Medical University , Beijing , PR China.|b Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology, Head and Neck Surgery (Capital Medical University) , Ministry of Education , Beijing , PR China.
authors.forename: Xinxing
authors.initials: X
authors.lastname: Fu
authors.affiliation: c Department of Bioinformatic , Wuerzburg University , Wuerzburg , Germany.
authors.forename: Chunfang
authors.initials: C
authors.lastname: Zhang
authors.affiliation: d Department of Endocrinology , Beijing Tongren Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Xuelian
authors.initials: X
authors.lastname: Zhang
authors.affiliation: a Department of Otolaryngology, Head and Neck Surgery , Beijing Tongren Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Shouqin
authors.initials: S
authors.lastname: Zhao
authors.affiliation: a Department of Otolaryngology, Head and Neck Surgery , Beijing Tongren Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Yongxin
authors.initials: Y
authors.lastname: Li
mesh_terms: D001299:Audiometry / Q000379:methods*; D048909:Diabetes Complications / Q000150:complications*; D034381:Hearing Loss / Q000175:diagnosis* / Q000209:etiology; D006801:Humans
keywords: Otoacoustic emission; diabetes mellitus; hearing loss; meta-analysis