The Association Between Tinnitus and Pan Immune Inflamation Value in Patients with Type 2 Diabetes Mellitus and Allergic Rhinitis

Objective:Tinnitus is a prevalent otologic symptom with a multifactorial etiology. Systemic inflammation and microvascular dysfunction have been proposed as key contributors to its pathophysiology. Diabetes mellitus (DM), a chronic metabolic disorder characterized by persistent low-grade inflammation and vascular impairment, may adversely affect the auditory system. This study aimed to evaluate and compare complete blood count (CBC)–derived inflammatory markers in diabetic and non-diabetic patients with subjective tinnitus and concomitant allergic rhinitis.Methods:This retrospective study included 230 patients presenting with subjective tinnitus, normal hearing thresholds, and allergic rhinitis. The patients were divided into two groups according to diabetes status: diabetic tinnitus (DM-T, n=115) and non-diabetic tinnitus (Non-DM-T, n=115). Demographic characteristics and laboratory data were obtained from medical records. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV) were calculated for each patient. The groups were compared using appropriate statistical analyses.Results:Age and sex distributions were comparable between the groups. Comparative analyses demonstrated that NLR, SII, and PIV values were significantly lower in the DM-T group than in the Non-DM-T group (p=0.007, p=0.003, and p=0.004, respectively). No significant differences were observed in LMR (p=0.380) or SIRI (p=0.093). These findings suggest a distinct inflammatory marker profile in diabetic patients with tinnitus.Conclusion:Diabetes mellitus appears to modulate systemic inflammatory responses in patients with tinnitus and allergic rhinitis, resulting in lower levels of certain composite inflammatory indices. CBC-derived markers such as NLR, SII, and PIV may serve as practical and accessible indicators of the interaction between metabolic disease and tinnitus-related inflammation. Prospective studies incorporating tinnitus severity scales and detailed metabolic parameters are warranted to clarify the clinical implications of these findings.