Relationship between levels of plasma endothelin-1/serum nitric oxide and hearing impairment in type 2 diabetes

AIM: To evaluate the relationship between endothelin-1 (ET-1)/nitric oxide (NO) and hearing impairment in type 2 diabetes mellitus (DM).METHODS: Eighty-eight type 2 diabetic patients with no signs of microangiopathy (retinopathy and nephropathy) or peripheral neuropathy, and 53 healthy subjects in the same period were enrolled in this study. Auditory function was evaluated using pure tone audiometry. Totally,type 2 DM group (n=88) and normal control group (NC, n=53) were divided into subgroups based on the presence and absence of hearing impairment. The concentration of plasma ET-1 was detected by radioimmunoassay. The concentration of serum NO was measured by the method of nitric acid reductase.RESULTS: Significantly increased plasma ET-1 and decreased serum NO were observed in diabetic patients with hearing impairment compared with those in diabetic patients without hearing impairment. The results of multivariate logistic regression analysis showed that hearing impairment in type 2 DM group was significantly associated with elevated level of HbA1c (OR＝4.525, P<0.05), LDL-C (OR=2.381,P<0.05) and plasma ET-1 (OR＝6.207,P<0.01). Besides, elevated serum level of NO (OR＝0.862, P<0.05) was associated with lower risk of hearing impairment in diabetics.CONCLUSION: Hearing impairment may happen earlier than other complications in diabetic patients. In addition to hyperglycemia and hyperlipemia, high level of ET-1 and low levels of NO might contribute to hearing impairment in diabetic patients.