Benign paroxysmal positional vertigo and serum transthyretin in Chinese older adults

Poor nutritional status is associated with benign paroxysmal positional vertigo (BPPV). Transthyretin (TTR) is a more sensitive marker than is albumin for nutritional status assessment. This study was conducted to confirm an association between serum transthyretin levels and BPPV.

In total, 320 patients with BPPV and 320 age- and gender-matched controls were recruited between July 1, 2018, and July 1, 2020. All patients underwent audiovestibular tests, including the Dix-Hallpike test for the posterior semicircular canal and the supine roll test for the horizontal semicircular canal. Furthermore, serum transthyretin levels and other biochemical indicators were tested. Risk factors, including a history of heart and cerebral vascular diseases, were examined, and compared between groups. Hematolgical and biochemical tests were performed and subjected to between-group analysis. Multiple logistic regression models were employed to evaluate the TTR-BPPV. Interaction and stratified analyses were conducted.

Patients with BPPV had significantly lower TTR levels than controls (213±49.3 vs 284±56.4 p<0.001). Alcohol consumption and anemia played an interactive role in the association between BPPV and low TTR levels. After adjustments for triglycerides, BMI, uric acid, HbA1C, 25-OH vitamin D3, alcohol consumption, and anemia, the multiple logistic regression revealed that participants with low TTR levels had a significantly increased risk of BPPV (OR: 5.5; 95% CI, 2.55-11.9; p<0.001).

Chinese older adults with low serum transthyretin levels have an increased risk of BPPV.