Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA.
Eur J Clin Nutr. 2018 May;72(5):720-727. doi: 10.1038/s41430-018-0101-6. Epub 2018 Jan 29.
BACKGROUND/OBJECTIVES: Studies based on food frequency questionnaires suggest that folate and vitamin B12 intake could protect against hearing loss. We investigated whether erythrocyte folate and serum vitamin B12 levels are independently associated with hearing loss in humans.
SUBJECTS/METHODS: Participants in the 2003-2004 US National Health and Nutrition Examination Survey who had data on hearing, folate, and vitamin B12 levels were included. Pure-tone average (PTA) at 0.5, 1.0, 2.0, and 4.0 kHz was computed for each ear. We used weighted logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the relation between quartiles of folate and vitamin B12, and hearing loss (present if PTA > 25 dB in either ear and absent if PTA ≤ 25 dB in both ears).
Participants (n = 1149) were 20-69 (mean 42) years old and 16.4% had hearing loss in at least one ear. Our data suggest a U-shaped relationship between folate and hearing loss. Compared to the 1st quartile, the ORs (95% CIs) for hearing loss were 0.87 (0.49-1.53), 0.70 (0.49-1.00), and 1.08 (0.61-1.94) for the 2nd, 3rd, and 4th quartile of erythrocyte folate in analyses adjusted for age, sex, vitamin B12, smoking, alcohol use, body mass index, race/ethnicity, exposure to noise, income, and education. Although we observed inverse associations between vitamin B12 and hearing loss, the associations were not statistically significant (P > 0.05).
Our data show a U-shaped relationship between erythrocyte folate levels and hearing loss, suggesting a need to evaluate whether optimizing blood folate levels could prevent hearing loss.
背景/目的：基于食物频率问卷的研究表明，叶酸和维生素 B12 的摄入可以预防听力损失。我们研究了红细胞叶酸和血清维生素 B12 水平是否与人类听力损失独立相关。
纳入了 2003-2004 年美国国家健康和营养调查中既有听力数据又有叶酸和维生素 B12 水平数据的参与者。计算每个耳朵的纯音平均听力（PTA）在 0.5、1.0、2.0 和 4.0 kHz 处的值。我们使用加权 logistic 回归来估计叶酸和维生素 B12 四分位数与听力损失（如果任何一只耳朵的 PTA>25dB 则存在，如果两只耳朵的 PTA≤25dB 则不存在）之间的关系的比值比（OR）和 95%置信区间（CI）。
参与者（n=1149）年龄为 20-69 岁（平均 42 岁），16.4%的人至少一只耳朵有听力损失。我们的数据表明叶酸与听力损失之间存在 U 形关系。与第 1 四分位相比，红细胞叶酸第 2、3 和 4 四分位的听力损失的 OR（95%CI）分别为 0.87（0.49-1.53）、0.70（0.49-1.00）和 1.08（0.61-1.94），分析调整了年龄、性别、维生素 B12、吸烟、饮酒、体重指数、种族/民族、噪音暴露、收入和教育。尽管我们观察到维生素 B12 与听力损失之间存在负相关，但相关性没有统计学意义（P>0.05）。
我们的数据显示红细胞叶酸水平与听力损失之间呈 U 形关系，这表明需要评估是否优化血液叶酸水平可以预防听力损失。
