الفهرس 
Vitamin DOnly 14 pages are availabe for public view
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Abstract
Background: Consider high prevalence of vitamin D deficiency and its important role in many physiological processes within the inner ear. Vitamin D is a key regulator of calcium absorption and bone metabolism that affect calcium homeostasis as calcium ions that play an important role in conduction of electrical impulses between nerve fibers and hair cell transduction. In addition, low serum vitamin D could be a cause of labyrinthine demineralization and in particular otoconial fragility. Vitamin D has a strong immunomodulatory role and regulation the expression of pro-inflammatory mediators. Its deficiency has been associated to increase the inflammatory processes in the inner ear.
Aim of the work: Study relation between vitamin D level and audio-vestibular disorders.
Subjects and Methods: The present study was conducted on 214 subjects divided into two groups; study group included 107 adults who suffered from common audio-vestibular disorders while control group consisted of 107 volunteers with no audio-vestibular abnormalities. Both groups were subdivided according to age into adult group (30-59) and senior group (60-70) years old. All the participants underwent audiological, vestibular evaluation, laboratory measurement of serum 25-hydroxyvitamin D3. Bone mineral density (BMD) was measured in the study group only at lumbar spine (L1–L4), proximal femur and mid ultra 1/3 forearm. The approach of interpretation of Dual-Energy X-ray Absorptiometry (DXA) for Assessment of Bone Density was reported by Choplin et al., (2014).
Results: Serum 25(OH) D3 levels were significantly lower in BPPV patients compared to control group. Patients with recurrent episodes of BPPV had significantly more low average (10.00 ± 5.25 ng/ml) serum level of 25(OH) D₃ than patients with a first episode (13.47 ± 7.77). 25(OH)D₃ level in presbycusis patients is lower compared with the senior adult controls [14.00 ± 7.39 ng/ml vs. 16.01 ± 8.62 ng/ml] with no significant difference. Current study demonstrated that vitamin D deficiency and decreased femur & forearm bone mineral density have inverse correlation with hearing thresholds. Severe vitamin D deficiency (<10ng/dl) and osteoporosis have the highest hearing thresholds. The mean 25(OH)D3 level was 14.07 ± 4.76 ng/mL in the Otosclerosis patients. Although the mean 25(OH)D3 level was lower in Otosclerosis group yet the difference from control was not statistically significant. There were significant inverse correlation between bone mineral density obtained from femur neck, forearm and mean air, bone conduction hearing thresholds. While in Meniere’s disease mean 25(OH)D₃ level was 18.16 ± 4.62 ng/mL with no association found between vitamin D deficiency and occurrence or degree of hearing loss
Conclusions: The incidence of vitamin D deficiency is common in patients suffered from BPPV and presbycusis. In the current study results proved a strong relation between vitamin D₃ deficiency and BPPV disorder. Moreover vitamin D deficiency and low bone mineral density are an independent risk factor for age related hearing loss.