Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.
Am J Med. 2013 Dec;126(12):1142.e1-8. doi: 10.1016/j.amjmed.2013.04.026. Epub 2013 Oct 11.
Acquired hearing loss is highly prevalent, but prospective data on potentially modifiable risk factors are limited. In cross-sectional studies, higher body mass index (BMI), larger waist circumference, and lower physical activity have been associated with poorer hearing, but these have not been examined prospectively.
We examined the independent associations between BMI, waist circumference, and physical activity, and self-reported hearing loss in 68,421 women in the Nurses' Health Study II from 1989 to 2009. Baseline and updated information on BMI, waist circumference, and physical activity was obtained from biennial questionnaires.
After more than 1.1 million person-years of follow-up, 11,286 cases of hearing loss were reported to have occurred. Higher BMI and larger waist circumference were associated with increased risk of hearing loss. Compared with women with BMI <25 kg/m(2), the multivariate-adjusted relative risk (RR) for women with BMI ≥ 40 was 1.25 (95% confidence interval [CI], 1.14-1.37). Compared with women with waist circumference <71 cm, the multivariate-adjusted RR for waist circumference >88 cm was 1.27 (95% CI, 1.17-1.38). Higher physical activity was related inversely to risk; compared with women in the lowest quintile of physical activity, the multivariate-adjusted RR for women in the highest quintile was 0.83 (95% CI, 0.78-0.88). Walking 2 hours per week or more was associated inversely with risk. Simultaneous adjustment for BMI, waist circumference, and physical activity slightly attenuated the associations but they remained statistically significant.
Higher BMI and larger waist circumference are associated with increased risk, and higher physical activity is associated with reduced risk of hearing loss in women. These findings provide evidence that maintaining healthy weight and staying physically active, potentially modifiable lifestyle factors, may help reduce the risk of hearing loss.
获得性听力损失的发病率很高，但关于潜在可改变的危险因素的前瞻性数据有限。在横断面研究中，较高的体重指数（BMI）、较大的腰围和较低的身体活动水平与听力较差相关，但这些因素尚未进行前瞻性研究。
我们研究了 BMI、腰围和身体活动与护士健康研究 II 中 68421 名女性在 1989 年至 2009 年期间自我报告的听力损失之间的独立关联。通过两年一次的问卷调查获得 BMI、腰围和身体活动的基线和更新信息。
在超过 110 万个人年的随访后，报告了 11286 例听力损失病例。较高的 BMI 和较大的腰围与听力损失风险增加相关。与 BMI<25kg/m²的女性相比，BMI≥40kg/m²的女性的多变量调整相对风险（RR）为 1.25（95%置信区间[CI]，1.14-1.37）。与腰围<71cm 的女性相比，腰围>88cm 的女性的多变量调整 RR 为 1.27（95%CI，1.17-1.38）。较高的身体活动与风险呈负相关；与身体活动最低五分位数的女性相比，身体活动最高五分位数的女性的多变量调整 RR 为 0.83（95%CI，0.78-0.88）。每周步行 2 小时或以上与风险呈负相关。同时调整 BMI、腰围和身体活动略微减弱了这些关联，但它们仍然具有统计学意义。
较高的 BMI 和较大的腰围与风险增加相关，而较高的身体活动与女性听力损失风险降低相关。这些发现提供了证据表明，保持健康的体重和积极的身体活动，这些潜在可改变的生活方式因素，可能有助于降低听力损失的风险。
