全身炎症和代谢生物标志物与突发性感音神经性听力损失初始听力损失严重程度的关系
Systemic inflammatory and metabolic biomarkers in relation to initial hearing loss severity in sudden sensorineural hearing loss.
文献信息
| PMID | 42983559 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Jianxiang Han |
| 作者单位 | Department of Clinical Laboratory, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, 211102, China. |
| 期刊 | Head & face medicine |
| SCI 分区 | Q2 |
| IF | 3.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估常规检测的全身炎症和代谢生物标志物是否与突发性感音神经性听力损失（SSNHL）患者就诊时初始听力损害的严重程度相关。
方法： 这项回顾性病例对照研究纳入2020年1月至2024年12月期间接受治疗的613例成人SSNHL住院患者，以及同期接受常规健康体检的850名健康个体。根据基线纯音平均听阈（PTA）听力学评估，将听力损失严重程度分为轻度、中度、重度和极重度。连续变量以中位数（四分位距）汇总，并采用非参数检验进行比较。采用序数logistic回归评估与PTA定义严重程度的关联，并依次调整人口学和代谢协变量。评估了共线性、模型拟合、比例优势假设、缺失情况以及敏感性分析。
结果： 与对照相比，SSNHL患者的总胆固醇、LDL-C、血糖、中性粒细胞计数、NLR、血小板计数、PLR、MPV和ApoA1较高，淋巴细胞计数和甘油三酯较低。在SSNHL患者中，严重程度分布为轻度320例（52.2%）、中度155例（25.3%）、重度88例（14.4%）、极重度50例（8.1%）。跨严重程度类别，白蛋白和HDL-C呈下降趋势，而年龄、血糖、甘油三酯、纤维蛋白原和D-二聚体呈上升趋势。在序数logistic回归中，白蛋白在仅含生物标志物的模型中与严重程度相关（OR 0.928，95% CI 0.880-0.978，P = 0.006），但在调整年龄、性别、血糖、甘油三酯和HDL-C后，该关联减弱（OR 0.970，95% CI 0.915-1.028，P = 0.302）。在完全调整模型中，年龄、男性性别和血糖仍与更严重的程度相关。
结论： 与对照相比，SSNHL伴有可检测到的全身炎症和代谢差异。然而，在调整人口学和代谢协变量后，初始听力损失严重程度并不能由NLR、PLR、LDL-C或白蛋白独立解释。白蛋白可被视为全身营养-炎症状态的候选标志物，但其与严重程度相关的关联应谨慎解读，并需要前瞻性验证。
英文摘要
OBJECTIVE: To assess whether routinely measured systemic inflammatory and metabolic biomarkers are related to the initial severity of hearing impairment in patients presenting with sudden sensorineural hearing loss (SSNHL).
METHODS: This retrospective case-control study included 613 adult inpatients with SSNHL treated between January 2020 and December 2024 and 850 healthy individuals undergoing routine health examination during the same period. Hearing loss severity was classified into mild, moderate, severe, and profound categories according to the baseline pure-tone average (PTA)-based audiological assessment. Continuous variables were summarized as median (interquartile range) and compared using non-parametric tests. Associations with PTA-defined severity were evaluated using ordinal logistic regression, with sequential adjustment for demographic and metabolic covariates. Collinearity, model fit, proportional odds assumption, missingness, and sensitivity analyses were assessed.
RESULTS: Compared with controls, patients with SSNHL had higher total cholesterol, LDL-C, glucose, neutrophil count, NLR, platelet count, PLR, MPV, and ApoA1, and lower lymphocyte count and triglycerides. Among patients with SSNHL, the severity distribution was mild in 320 patients (52.2%), moderate in 155 (25.3%), severe in 88 (14.4%), and profound in 50 (8.1%). Across severity categories, albumin and HDL-C tended to decrease, whereas age, glucose, triglycerides, fibrinogen, and D-dimer tended to increase. In ordinal logistic regression, albumin was associated with severity in the biomarker-only model (OR 0.928, 95% CI 0.880-0.978, P = 0.006), but this association was attenuated after adjustment for age, sex, glucose, triglycerides, and HDL-C (OR 0.970, 95% CI 0.915-1.028, P = 0.302). Age, male sex, and glucose remained associated with greater severity in the fully adjusted model.
CONCLUSION: SSNHL was accompanied by detectable systemic inflammatory and metabolic differences compared with controls. However, initial hearing loss severity was not independently explained by NLR, PLR, LDL-C, or albumin after adjustment for demographic and metabolic covariates. Albumin may be considered a candidate marker of systemic nutritional-inflammatory status, but its severity-related association should be interpreted cautiously and requires prospective validation.