(235) Statin use and sensorineural hearing loss in patients with type 2 diabetes: Evidence from a population-based case-control study

Publication Number: 1226

Background: Several previous experimental and clinical studies have reported the impacts of statin on hearing loss. Although statins have been suggested as preventive and therapeutic agents for dyslipidemia, their effect on sensorineural hearing loss (SNHL) is unclear.

Objectives: This study aimed to investigate the association between statin use and the risk of sensorineural hearing loss in patients with type 2 diabetes mellitus (DM) aged ≥18 years using population-based data.

Methods: This case-control study was performed using the Korean National Health Insurance Service -National Sample Cohort enrolled from 2002-2019. SNHL was defined with ICD-10 codes (H912, H903-H905, H910, H931; International Statistical Classification of Diseases, 10th Revision). To increase the validity of the SNHL diagnosis, cases diagnosed by an otolaryngology department were included. The definition included participants who underwent an audiometry test with 37 number codes. Patients were also defined as patients who had been prescribed steroids, including an audiometry test performed 30 days before diagnosis of SNHL. Patients were considered exposed to statin if they had ever been prescribed any statins (atorvastatin, fluvastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin, and lovastatin) within 2 years before the index date.
Patients who were previously diagnosed with SNHL between 2002 and 2003 were excluded. Controls were randomly matched to cases at a ratio of 4:1 by age, sex, and index year. The odds ratios (ORs) and adjusted ORs from the chi-square test and the logistic regression model.

Results: A total of 130,764 types 2 DM patients were eligible for this study. Among them, 2,098 patients with SNHL and 8,392 sex-, age-, and index year-matched controls were finally included. After adjusting confounders, the use of statin was a significant factor in increasing the risk of hearing loss (adjusted OR 1.706, 95% Confidence Interval (CI) 1.576-1.845). In a statin dose-dependent strength analysis, low-intensity (adjusted OR 1.309, 95% CI 1.064-1.611), moderate-intensity(adjusted OR 1.562, 95% CI 1.447-1.687), and high-intensity (adjusted OR 1.284, 95% CI 1.045-1.577) groups increased the risk of developing SNHL and were statistically significant. In the statin type analysis, atorvastatin (adjusted OR 1.508, 95% CI 1.392-1.634) and simvastatin (adjusted OR 1.483, 95% CI 1.298-1.694) increased the risk of SNHL, but the other types were not significant.
conclusion:This study revealed that the use of statins in patients with type 2 diabetes mellitus significantly increased the risk of sensorineural hearing loss. For the association between statins and SNHL, further research on the precise mechanism is needed.