Metabolic Syndrome as a Risk Factor for Sensorineural Hearing Loss in Adult Patients with Turner Syndrome

Abstract

Background and purpose

Metabolic syndrome (MetS) is a disorder associated with an increased risk of cardiovascular disease. The frequency of each component of MetS in Turner syndrome (TS) subjects is high. An elevated incidence of hearing loss has also been reported in TS. Sensorineural hearing loss (SNHL) affects at least half of young women with TS. The association between MetS and SNHL has not been previously considered in TS. The aim of this study is to evaluate the association between these two conditions.

Patients and Methods

Cross-sectional anthropometric, cardio-metabolic and audiological data were obtained from a cohort consisting of unrelated TS subjects (>20 years of age; n = 93). Metabolic syndrome was defined according to the International Diabetes Federation criteria. Types and severity of hearing loss were based on the American Speech Hearing Association guidelines.

Results

Hearing loss was detected in 74% of ears from adult TS subjects and SNHL was observed in half of our TS subjects. The prevalence of MetS in TS subjects with or without SNHL was 64% and 11%, respectively (P < 0.05). After adjusting for age, MetS was related to a ninefold increase in the odds of SNHL. This odds increased in a stepwise manner as the number of MetS components increased.

Conclusion

MetS and its individual components were associated factors for SNHL in TS subjects. A reduction in the number and severity of the components of MetS might potentially contribute to decreasing the progression of SNHL at younger ages, but further studies will be needed to explain the underlying pathological mechanism connecting MetS and SNHL.

Keywords:

• hearing loss
• metabolic syndrome
• risk factors
• Turner syndrome

Statement of Ethics

The study protocol was reviewed and approved by the Ethics Committee´s for Research in Human Subjects of the two participating institutions. The ethical principles of the 1964 Declaration of Helsinki for medical research were adhered to throughout this research. The procedures and possible discomfort/risks were fully explained to all participating subjects before beginning the study. Each then voluntarily decided to take part in the study and approved their participation and signed an informed written consent form in front of a witness. Subjects were provided with the option to withdraw their participation in the study at any time without consequence.

Acknowledgments

We are extremely grateful to all women with Turner syndrome who took part in this study. We acknowledge the contribution of Ecuadorian Foundation in Support of Turner Syndrome. The authors would like to thank the Consejo de Desarrollo Científico, Humanístico y Tecnológico (CONDES) from University of Zulia, Maracaibo, Venezuela who provided assistance with the program. This study was supported by the Academie de Recherche et D’Enseignement Superieur of Belgique (grant number 2016-157E); and Training Research Commission, General Directorate of Research and Postgraduate from Central University of Ecuador (grant number cif3-cv-fcb-2).

Disclosure

The authors declare that they have nothing to disclose and there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.