Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.
Mitsubishi Plastics, Inc., Tokyo, Japan.
Clin Nutr. 2020 Mar;39(3):870-875. doi: 10.1016/j.clnu.2019.03.020. Epub 2019 Mar 27.
BACKGROUND & AIMS: The existing yet limited prospective studies reported conflicting results about obesity and hearing loss. We investigated the prospective association between obesity and hearing loss in a large-scale Japanese working population, as well as the association between metabolic phenotype and hearing loss.
The study included 48,549 employees aged 20-64 years and free of hearing loss at baseline. Pure-tone audiometric testing was performed annually to identify hearing loss at 1 and 4 kHz. Cox proportional hazards regression was used to investigate the risk of hearing loss associated with body mass index (BMI) and metabolic phenotype (based on a BMI of ≥25.0/<25.0 kg/m and presence/absence of ≥2 components of metabolic syndrome, except waist circumference). Baseline and updated information were obtained from annual health checkups.
With a median follow-up of 7 years, 1595 and 3625 individuals developed unilateral hearing loss at 1 and 4 kHz, respectively. The adjusted hazard ratios (HR) for hearing loss at 1 kHz were 1.21 (1.08, 1.36) and 1.66 (1.33, 2.08) for those with BMI 25.0-29.9 kg/m and BMI ≥30.0 kg/m, respectively, compared to individuals with BMI <25.0 kg/m. For hearing loss at 4 kHz, the corresponding HRs were 1.14 (1.05, 1.23) and 1.29 (1.09, 1.52). Compared with metabolically healthy non-obese individuals, the adjusted HRs for hearing loss at 1 kHz were 1.19 (1.03, 1.39), 1.27 (1.01, 1.61), and 1.48 (1.25, 1.76) for unhealthy non-obese, healthy obese, and unhealthy obese individuals, respectively. For hearing loss at 4 kHz, the corresponding HRs were 1.13 (1.04, 1.25), 1.21 (1.04, 1.41), and 1.26 (1.12, 1.41).
Overweight and obesity are associated with an increased risk of hearing loss, and metabolically unhealthy obesity may confer additional risk.
现有的前瞻性研究对肥胖与听力损失之间的关系结果存在争议。本研究旨在调查大型日本在职人群中肥胖与听力损失之间的前瞻性关联，以及代谢表型与听力损失之间的关联。
本研究纳入了 48549 名年龄在 20-64 岁、基线时无听力损失的员工。每年进行纯音测听以检测 1 和 4 kHz 处的听力损失。采用 Cox 比例风险回归分析 BMI（体重指数）和代谢表型（基于 BMI≥25.0/<25.0 kg/m 和代谢综合征的存在/不存在，除腰围外，还包括≥2 个组成部分）与听力损失相关的风险。基线和更新信息来自年度健康检查。
中位随访 7 年后，1595 人和 3625 人分别在 1 kHz 和 4 kHz 处单侧出现听力损失。与 BMI<25.0 kg/m 的个体相比，BMI 为 25.0-29.9 kg/m 和 BMI≥30.0 kg/m 的个体患 1 kHz 听力损失的调整后风险比（HR）分别为 1.21（1.08，1.36）和 1.66（1.33，2.08）。对于 4 kHz 的听力损失，相应的 HR 分别为 1.14（1.05，1.23）和 1.29（1.09，1.52）。与代谢健康的非肥胖个体相比，1 kHz 听力损失的调整后 HR 分别为 1.19（1.03，1.39）、1.27（1.01，1.61）和 1.48（1.25，1.76），不健康的非肥胖个体、健康肥胖个体和不健康肥胖个体。对于 4 kHz 的听力损失，相应的 HR 分别为 1.13（1.04，1.25）、1.21（1.04，1.41）和 1.26（1.12，1.41）。
超重和肥胖与听力损失风险增加相关，代谢不健康的肥胖可能会带来额外的风险。
