Study on the relationship between coagulation function, homocysteine, serum oxidative stress and sudden deafness and its clinical implications

Sudden sensorineural hearing loss (SSHL) is characterized by an abrupt, unexplained decline in hearing, typically affecting one ear. Although coagulation abnormalities, homocysteine (Hcy), and oxidative stress have been implicated in SSHL, their combined diagnostic value remains insufficiently defined. This study aimed to investigate the associations between coagulation parameters, Hcy, oxidative stress markers, and SSHL, and to evaluate their diagnostic significance. Ninety-five patients with SSHL and 95 age- and sex-matched healthy controls were enrolled between February 2022 and February 2023. Coagulation indices (APTT, INR, TT, fibrinogen [FIB], and D-dimer), Hcy, and oxidative stress markers (nitric oxide [NO], endothelin [ET], and plasma superoxide dismutase [P-SOD]) were measured. Compared with controls, SSHL patients had significantly lower FIB and higher D-dimer levels (both P < 0.05). NO and P-SOD were decreased, whereas ET was elevated (P < 0.05). Multivariate logistic regression identified lower FIB (OR = 0.356, 95% CI: 0.204–0.620, P < 0.001) and lower P-SOD (OR = 0.152, 95% CI: 0.043–0.542, P = 0.004) as independent factors associated with SSHL, while elevated Hcy significantly increased disease risk (OR = 6.417, 95% CI: 1.22–33.89, P = 0.029). Receiver operating characteristic analysis demonstrated good diagnostic performance for individual biomarkers, with AUCs of 0.776 for FIB, 0.877 for Hcy, and 0.810 for P-SOD. Notably, the combined model achieved superior diagnostic accuracy (AUC = 0.925, 95% CI: 0.88–0.97). These findings indicate that combined assessment of coagulation, metabolic, and oxidative stress markers may improve early diagnosis and risk stratification of SSHL.