Blood homocysteine and folic acid levels may provide reference value for the treatment of sudden total frequency deafness

Abstract

Background: The cause of sudden sensorineural hearing loss (SSNHL) is still unknown. Literature has indicated that there is a statistically significant correlation between hyperhomocysteinemia and SSNHL, yet there is lack of study in the relationship concerning total frequency deafness subtype of SSNHL. This study investigated the relationship between plasma concentration of homocysteine (Hcy), serum concentration of folic acid and occurrence and treatment responding in total frequency deafness adult patients, and explored whether targeted early intervention was associated with improved clinical outcome in this subgroup.Methods: A total of 54 consecutive adult patients with diagnosis of sudden total frequency deafness in a single institution was enrolled into the study group. Two control groups were established. Control group 1 was derived from inpatients with normal listening comprehension. Control group 2 included 52 patients with sudden total frequency deafness treated in a parallel hospital. Blood concentration of folic acid and Hcy was investigated. Treatment included Ginkgo biloba extract, dexamethasone, hyperbaric oxygen, folic acid, vitamin B6, and optional vitamin B12. All data was statistically analyzed. Blood level of Hcy and folic acid was compared between study group and control group 1.Results: Although there was no clear evidence for the divergence trend of Hcy and folic acid levels individually, the results showed that the study group had higher blood level of Hcy and lower blood level of folic acid, than control group. In the study group, 24 patients (44.44%) demonstrated treatment effectiveness after the 2-week treatment course. Patients without vertigo had higher effective rate than patients with vertigo (P<0.05).Conclusions: Effective rate of study group was higher than control group 2 which had no folic acid and vitamin B6/B12 supplement. High blood Hcy and low blood folic acid were closely associated in patients with sudden total frequency deafness. The currently accepted concept of treatment for sudden total frequency deafness is not essentially satisfactory. Testing of plasma Hcy and serum folic acid may provide referential value for its treatment and prognosis evaluation.

Analysis of the association and predictive value of hyperhomocysteinaemia for obstructive coronary artery disease

“…19 Research has demonstrated close correlations between plasma Hcy levels and age, sex and smoking. 35 This current study grouped the patients with obstructive CAD into young patients (aged 55 years) and old patients (aged > 55 years). Multivariate logistic regression analysis identified HHcy as an independent risk factor not only in young patients with obstructive CAD but also in old patients with obstructive CAD after adjusting for other risk factors.…”

The Role of Fibrinogen, Homocysteine and Metabolic Syndrome’s Alterations in Sudden Sensorineural Hearing Loss (SSHL): A Narrative Review

“…Regarding the clinical effects of HCY on SSHL patients, Huang et al conducted a study to investigate the association between plasma HCY concentration, serum folic acid concentration, and treatment occurrence and response in adult patients with total frequency deafness. The aim of this study was to test the hypothesis that higher plasma HCY levels, in association with lower serum folic acid levels, may be associated with a higher risk of sudden total frequency deafness [27]. Indeed, the researchers found that plasma HCY levels were elevated, and serum folic acid levels were decreased in patients with sudden hearing loss compared with the normal control group, with statistically significant differences (p < 0.05).…”

“…Currently, two main factors are widely recognized for the development of hyperhomocysteinemia: (I) nutritional elements characterized by a deficiency of metabolic cofactors such as vitamin B6, vitamin B12, and/or folic acid, and (II) genetic factors, including mutations in genes such as MTHFR and CBS, which may reduce enzyme activity. These factors may contribute to the accumulation of HCY in the body [27].…”

“…Huang et al attempted to administer folic acid, vitamin B6, and B12 to patients with SSHL, but their results showed no improvement in clinical outcomes. Nevertheless, they suggest that maintaining low levels of HCY in daily life may prove beneficial for the clinical prevention and treatment of hearing loss [27].…”