Fischer Mary E, Cruickshanks Karen J, Dillard Lauren K, Nondahl David M, Klein Barbara E K, Klein Ronald, Pankow James S, Tweed Ted S, Schubert Carla R, Dalton Dayna S, Paulsen Adam J
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI.
Department of Population Health Sciences, University of Wisconsin, Madison, WI.
J Am Acad Audiol. 2019 Apr;30(4):282-292. doi: 10.3766/jaaa.17079. Epub 2018 Feb 13.
Associations between vascular health-related factors and hearing loss defined using audiometric pure-tone thresholds have been found. Studies have not focused on a potential relationship between vascular health-related factors and central auditory processing.
The aim of this study was to evaluate, on a population level, the relationship of vascular health-related factors with central auditory function.
A cross-sectional, population study.
Subjects were participants in the Epidemiology of Hearing Loss Study (EHLS) or the Beaver Dam Offspring Study (BOSS)-prospective studies of aging and sensory loss. BOSS participants were the adult offspring of participants in the EHLS. Participants who completed the Dichotic Digits Test (DDT) during the fourth examination period of the EHLS (2008-2010) or the second examination period of the BOSS (2010-2013) were included (n = 3,655, mean age = 61.1 years).
The DDT-free recall test was conducted using 25 sets of triple-digit pairs at a 70 dB HL presentation level. The total number of correctly repeated digits from the right and left ears was converted to a percentage correct and used as an outcome. The percentage correct in the left ear was subtracted from the percentage correct in the right ear and used as an outcome. Vascular health-related measures obtained during the examination included blood pressure, mean carotid intima-media thickness, femoral pulse wave velocity (PWV), hemoglobin A1C, and non-high-density lipoprotein (HDL) cholesterol, and, in the EHLS participants, C-reactive protein and interleukin-6. Information on vascular health-related history and behaviors was self-reported. General linear modeling produced estimates of the age- and sex-adjusted least squares means for each vascular factor, and multiple linear regression was used for multivariable modeling of each outcome.
After multivariable adjustment, participants with diabetes had a significantly lower (worse) mean DDT-free recall total score (-2.08 percentage points, p < 0.001) than those without diabetes. Participants who exercised at least once per week had a significantly higher (better) mean DDT-free recall total score (+1.07 percentage points, p < 0.01) than those who did not exercise at least once per week. Alcohol consumption was associated with a higher DDT-free recall total score (+0.15 percentage points per +25 g ethanol, p < 0.01). In multivariable modeling of the right-left ear difference in DDT-free recall scores, participants with a history of cardiovascular disease (CVD) or higher PWV demonstrated significantly larger differences (CVD: +3.11 percentage points, p = 0.02; PWV: +0.36 percentage points per 1 m/sec, p < 0.01). Higher levels of non-HDL cholesterol were associated with smaller right-left ear differences (-0.22 percentage points per 10 mg/dL, p = 0.01). Adjustment for handedness did not affect the results.
Vascular health-related factors may play a role in central auditory function.
已发现血管健康相关因素与使用听力计纯音阈值定义的听力损失之间存在关联。研究尚未聚焦于血管健康相关因素与中枢听觉处理之间的潜在关系。
本研究的目的是在人群水平上评估血管健康相关因素与中枢听觉功能的关系。
一项横断面人群研究。
受试者为听力损失流行病学研究（EHLS）或比弗代姆后代研究（BOSS）的参与者——衰老与感觉丧失的前瞻性研究。BOSS参与者是EHLS参与者的成年后代。纳入在EHLS第四个检查期（2008 - 2010年）或BOSS第二个检查期（2010 - 2013年）完成双耳数字测试（DDT）的参与者（n = 3655，平均年龄 = 61.1岁）。
在70 dB HL的呈现水平下，使用25组三位数字对进行无DDT回忆测试。将左右耳正确重复数字的总数转换为正确百分比，并用作结果。用右耳正确百分比减去左耳正确百分比，并用作结果。检查期间获得的血管健康相关测量指标包括血压、平均颈动脉内膜中层厚度、股动脉脉搏波速度（PWV）、糖化血红蛋白A1C和非高密度脂蛋白（HDL）胆固醇，在EHLS参与者中还包括C反应蛋白和白细胞介素 - 6。关于血管健康相关病史和行为的信息通过自我报告获取。一般线性模型得出每个血管因素经年龄和性别调整的最小二乘均值估计值，多元线性回归用于每个结果的多变量建模。
经过多变量调整后，患有糖尿病的参与者无DDT回忆总分显著更低（更差）（-2.08个百分点，p < 0.001），低于无糖尿病者。每周至少锻炼一次的参与者无DDT回忆总分显著更高（更好）（+1.07个百分点，p < 0.01），高于每周至少锻炼一次的参与者。饮酒与更高的无DDT回忆总分相关（每增加25克乙醇，+0.15个百分点，p < 0.01）。在无DDT回忆分数的左右耳差异的多变量建模中，有心血管疾病（CVD）病史或更高PWV的参与者表现出显著更大的差异（CVD：+3.11个百分点，p = 0.02；PWV：每1米/秒 +0.36个百分点，p < 0.01）。更高水平的非HDL胆固醇与更小的左右耳差异相关（每10毫克/分升 -0.22个百分点，p = 0.01）。对利手的调整不影响结果。
血管健康相关因素可能在中枢听觉功能中起作用。
