Correlation Between Serum Trx、Trx80、Txnip And Diabetic Lesion Of Inner Ear

Objective: Through the joint study of otoacoustic emission,cervical vestibular myogenic evoked potential and serological indicators,starting with the subjective hearing loss caused by diabetes,we supplemented and expanded the samples in the previous experiment,explored the value of serum thioredoxin related indicators in the protection of cochlear and vestibular functions in diabetes,and provided pre diagnostic indicators for diabetes inner ear damage from a new perspective of antioxidant.Method: 46 patients with type 2 diabetes mellitus who went to the Endocrinology Department of the Second Affiliated Hospital of Dalian Medical University from May to August 2022 were included as the diabetes mellitus group(DM).At the same period,10 healthy people without hearing disorders were selected as the normal control group(NC).These 56 subjects were excluded from ear organic diseases and had no vertigo related symptoms.According to pure tone audiometry at 0.5,1.0,2.0 and 4.0k Hz in the diabetes mellitus group,the average threshold of air conduction(d B HL)>25d B on either side was regarded as abnormal hearing.The patients were divided into 19 diabetes hearing normal group(DM1)and 27 diabetes hearing impaired group(DM2).The same patient chose the ear with a higher average PTA.Collect the basic clinical indicators of 56 subjects,including age,gender,course of disease,glycosylated hemoglobin,diagnosis and treatment process,conscious hearing loss,tinnitus and other medical history.Besides,the evaluation data of otoacoustic emission examination of these subjects were collected.At the same time,14 people in DM2 group,12 people in DM1 group and 9 people in NC group completed the examination of cervical vestibular myogenic evoked potential(c VEMP).Except for the bilateral asymmetry ratio,the other indicators were also selected from the ear with higher average PTA.The serum levels of Trx,Txnip and Trx80 were measured by ELISA.SPSS and Graph Pad Prism were used to compare the general situation,otoacoustic emission indicators and serum levels of Trx,Txnip and Trx80,and analyze the correlation between serum levels of Trx,Txnip and Trx80 and otoacoustic emission and c VEMP,as well as the correlation between otoacoustic emission and c VEMP.The acquisition of all data has passed the ethical review of the Second Affiliated Hospital of Dalian Medical University.Results: 1.The age and course of disease in DM2 group were higher compared to DM1 group with statistically significant difference;2.The overall correlation,strength and signal-to-noise ratio of TEOAE in DM2 group were lower than those in NC group and DM1 group with statistically significant difference.There was no significant difference between DM1 and NC group.The DPOAE level and signal-to-noise ratio of each frequency in DM2 group decreased significantly between NC group and DM1 group.It appears no significant difference between DM1 and NC group;3.The serum Trx level in DM2 group was significantly higher than that in NC group,but there was no significant difference between DM2 group and DM1 group.There was no significant difference in serum Trx80 and Txnip levels among these groups;4.The serum Trx level in DM group was negatively correlated with the overall correlation,strength and signal to noise ratio of TEOAE,and negatively correlated with the signal to noise ratio of 0.5 k Hz and 1.0k Hz of DPOAE,with statistical significance;5.The level of serum Trx in DM group was positively correlated with the latency of c VEMP P1 wave,and the difference was statistically significant;6.The asymmetry ratio of c VEMP in DM group was negatively correlated with the correlation of TEOAE,the total value of signal-to-noise ratio and the level of DPOAE2.0k Hz,and the difference was statistically significant.The normal value of the examination was taken into the regression equation,and it was found that diabetes tended to damage the cochlea first,and the saccule afterwards.Conclusion: 1.Hearing loss in diabetes is related to the course of disease.Patients with diabetes with a long course of disease need to be particularly alert to the risk of hearing loss;2.Compared with Trx80 and Txnip,Serum Trx levels and TEOAE have higher sensitivity in suggesting the risk of hearing loss in diabetes.Serum Trx and the latency of c VEMP P1 has higher sensitivity in suggesting the decline of vestibular function in diabetes.3.The damage of diabetes to the inner ear is characterized by multi target simultaneous damage,and it is more likely to damage the cochlea first,and the saccule afterwards.