(860) Microvascular Disease Burden as a Risk Factor for Meniere's Disease: A Retrospective Multicohort TriNetX Study

Introduction: Microvascular injury and endothelial dysfunction are recognized contributors to Meniere’s disease (MD) pathogenesis. This study aims to examine the associations between microvascular conditions and incident MD and to evaluate the impact of vascular-targeted therapies, including antihypertensive and antidiabetic treatments, on MD risk using real-world data. Understanding these relationships could inform strategies for prevention and management.

Methods: A retrospective cohort study was conducted using the TriNetX database. Adult patients with microvascular conditions, including hypertension, type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and retinal microvascular disease, were identified and stratified by condition and exposure to ACE inhibitors/ARBs or GLP-1 receptor agonists. Propensity-score matching was used to balance baseline characteristics, and odds ratios were calculated for incident MD.

Results: Patients with one or more microvascular conditions had higher odds of incident MD (OR 1.77, 95% CI 1.67–1.87). Individually, hypertension (OR 1.99, 95% CI 1.83–2.18), T2DM (OR 1.44, 95% CI 1.14–1.83), and CKD (OR 1.65, 95% CI 1.03–2.64) were associated with increased risk. ACE inhibitor/ARB use lowered MD risk in hypertension (OR 0.87, 95% CI 0.82–0.93) and T2DM (OR 0.47, 95% CI 0.27–0.83), with a non-significant reduction in CKD (OR 0.77, 95% CI 0.34–1.75). GLP-1 receptor agonist use had a similar protective effect in hypertension (OR 0.33, 95% CI 0.24–0.47) and T2DM (OR 0.45, 95% CI 0.25–0.79).

Conclusions: Microvascular conditions, including hypertension, T2DM, and CKD, are linked to a higher risk of MD, and ACE inhibitor/ARB and GLP-1 receptor agonist use may mitigate this association.