Lee Doh Young, Kim Young Ho
Department of Otorhinolaryngology-Head and Neck Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2018 Oct;11(4):242-249. doi: 10.21053/ceo.2017.01641. Epub 2018 Apr 10.
Smoking is associated with hearing loss, while the correlation between tinnitus and smoking is not fully elucidated. This study aimed to evaluate risk factors of tinnitus in adolescents in terms of smoking, and we identified a rectifiable parameter that can be serially monitored.
A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey, with 2,782 participants aged 12 to 18 years, from 2008 through 2011. Participants with history of ear disease, hearing loss, and inadequate responses to questionnaires were excluded. We investigated the prevalence of tinnitus and tinnitus-related annoyance by questionnaire and sought potential risk factors in blood and urine tests and smoking history.
The prevalence of tinnitus in the 12- to 18-year-old population was 17.5%, with 3.3% reporting tinnitus-related annoyance. On univariate analysis, the prevalence of tinnitus increased with age (P<0.001) and was higher among girls (P=0.012). Blood tests and urinalysis showed significant correlation between tinnitus and red blood cell count, alkaline phosphatase levels, and urine cotinine (P=0.002, P<0.001, P=0.018, respectively). In multivariate analysis, the urine cotinine level was the only parameter associated with tinnitus (odds ratio, 1.000; 95% confidence interval, 0.999 to 1.000; P=0.038). Smoking was also significantly correlated with tinnitus (P=0.043), and amount of smoking with tinnitus-related annoyance (P=0.045). However, current smoking and past smoking were not correlated with tinnitus.
Urine cotinine may be a rectifiable marker for management of tinnitus in adolescents. This suggests that smoking cessation should be incorporated in the management of tinnitus in adolescents.
吸烟与听力损失有关，而耳鸣与吸烟之间的相关性尚未完全阐明。本研究旨在从吸烟角度评估青少年耳鸣的危险因素，并确定一个可连续监测的可纠正参数。
利用2008年至2011年韩国国家健康与营养检查调查的数据进行横断面研究，纳入2782名12至18岁的参与者。排除有耳部疾病、听力损失病史以及对问卷回答不充分的参与者。我们通过问卷调查耳鸣及与耳鸣相关烦恼的患病率，并在血液和尿液检查及吸烟史中寻找潜在危险因素。
12至18岁人群中耳鸣患病率为17.5%，3.3%报告有与耳鸣相关的烦恼。单因素分析显示，耳鸣患病率随年龄增加而升高（P<0.001），女孩中的患病率更高（P=0.012）。血液检查和尿液分析表明，耳鸣与红细胞计数、碱性磷酸酶水平及尿可替宁之间存在显著相关性（分别为P=0.002、P<0.001、P=0.018）。多因素分析中，尿可替宁水平是与耳鸣相关的唯一参数（比值比，1.000；95%置信区间，0.999至1.000；P=0.038）。吸烟也与耳鸣显著相关（P=0.043），吸烟量与与耳鸣相关的烦恼相关（P=0.045）。然而，当前吸烟和既往吸烟与耳鸣均无相关性。
尿可替宁可能是青少年耳鸣管理中的一个可纠正标志物。这表明戒烟应纳入青少年耳鸣的管理中。
