McMahon Catherine M, Kifley Annette, Rochtchina Elena, Newall Philip, Mitchell Paul
Centre for Language Sciences, Macquarie University, Sydney, Australia.
Ear Hear. 2008 Aug;29(4):578-84. doi: 10.1097/AUD.0b013e31817349d6.
Although it has been well established that the prevalence of and severity of hearing loss increase with age, the contribution of familial factors to age-related hearing loss cannot be quantified. This is largely because hearing loss in older people has both genetic and environmental contributions. As environmental factors play an increasing role with age, it is difficult to delineate the separate contribution of genetic factors to age-related hearing loss. In a population-based survey of hearing loss in a representative older Australian community, we attempted to overcome this using logistic regression analysis, accounting for known factors associated with hearing loss including age, sex, noise exposure at work, diabetes, and current smoking.
We tested hearing thresholds using pure tone audiometry and used a forced choice questionnaire to determine the nature of family history in a population of individuals aged 50 yrs or older in a defined region, west of Sydney, Australia (N = 2669). We compared the characteristics of participants with and without family history of hearing loss. Of those reporting a positive family history, we compared subgroups for age, gender and severity of hearing loss, and trends by the severity of hearing loss. Logistic regression was used to obtain odds ratios (ORs) with 95% confidence intervals (CIs) that compared the chances of having hearing loss in participants with and without family history, after adjusting for other factors known associated with hearing loss.
Our findings indicate that family history was most strongly associated with moderate to severe age-related hearing loss. We found a strong association between maternal family history of hearing loss and moderate to severe hearing loss in women (adjusted OR 3.0; 95% CI 1.6-5.6 in women with without a maternal history). Paternal family history of hearing loss was also significantly, though less strongly, associated with moderate-severe hearing loss in men (adjusted OR 2.0; CI 1.01-3.9 in men with than without a paternal history).
Findings from this study are important in the identification of individuals whose auditory system may be genetically susceptible to aging and environmental insult. Genetic counseling may assist in ameliorating the effects of hearing loss.
尽管听力损失的患病率和严重程度随年龄增长而增加这一点已得到充分证实，但家族因素对年龄相关性听力损失的影响尚无法量化。这主要是因为老年人的听力损失既有遗传因素，也有环境因素。随着年龄增长，环境因素的作用越来越大，因此很难界定遗传因素对年龄相关性听力损失的单独影响。在一项针对澳大利亚一个具有代表性的老年社区听力损失的人群调查中，我们试图通过逻辑回归分析来克服这一问题，该分析考虑了与听力损失相关的已知因素，包括年龄、性别、工作中的噪声暴露、糖尿病和当前吸烟情况。
我们使用纯音听力计测试听力阈值，并通过强制选择问卷来确定澳大利亚悉尼西部一个特定区域内50岁及以上人群（N = 2669）的家族史情况。我们比较了有听力损失家族史和无听力损失家族史参与者的特征。在那些报告有阳性家族史的人中，我们比较了按年龄、性别和听力损失严重程度划分的亚组，以及听力损失严重程度的趋势。在调整了其他已知与听力损失相关的因素后，使用逻辑回归来获得比值比（OR）及95%置信区间（CI），以比较有家族史和无家族史参与者发生听力损失的几率。
我们的研究结果表明，家族史与中度至重度年龄相关性听力损失的关联最为密切。我们发现母亲有听力损失家族史与女性中度至重度听力损失之间存在很强的关联（有母亲家族史的女性调整后OR为3.0；95%CI为1.6 - 5.6，无母亲家族史的女性为参照）。父亲有听力损失家族史与男性中度至重度听力损失也存在显著关联，尽管关联程度稍弱（有父亲家族史的男性调整后OR为2.0；CI为1.01 - 3.9，无父亲家族史的男性为参照）。
本研究结果对于识别听觉系统可能在遗传上易受衰老和环境损伤影响的个体具有重要意义。遗传咨询可能有助于减轻听力损失的影响。
