Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.
Atherosclerosis. 2019 Jun;285:10-16. doi: 10.1016/j.atherosclerosis.2019.03.012. Epub 2019 Mar 18.
The evidence concerning the association between hearing loss and stroke is limited. We aimed to investigate the association of hearing loss with risk of stroke and its subtypes among the middle-aged and older Chinese population.
We included 19,238 participants aged 64.6 years from the Dongfeng-Tongji Cohort in 2013. Hearing loss was classified into normal, mild, moderate, severe or greater levels by the pure tone average at speech frequency and high frequency, respectively. We calculated the odds ratios of hearing loss and stroke by logistic regression models.
With the increase of hearing loss level, the prevalence risk of stroke has gradually increased. Compared with normal hearing, participants having severe or greater hearing loss had a higher stroke risk of 76% and 39% at speech frequency and at high frequency, respectively. Similarly, individuals with severe or greater hearing loss had an increased risk of ischemic stroke of 69% and 52% at speech frequency and high frequency, respectively; while severe or greater hearing loss was associated with about a 2-fold risk of hemorrhagic stroke than normal hearing only at speech frequency. Stratified analysis suggested that some high cardiovascular risk participants such as male, age ≥65, exposed to occupational noise, smoker and with diabetes, hypertension or hyperlipidemia had higher risk of stroke. Furthermore, severe or greater hearing loss combined with age, diabetes, hypertension and hyperlipidemia had joint effects on stroke.
The results have suggested a dose-response relationship between hearing loss and stroke risk in middle-aged and older adults.
关于听力损失与中风之间关联的证据有限。我们旨在调查中国中老年人群中听力损失与中风风险及其亚型之间的关联。
我们纳入了 2013 年东风-同济队列中年龄为 64.6 岁的 19238 名参与者。听力损失通过言语频率和高频的纯音平均听力水平分别分为正常、轻度、中度、重度或更重度。我们通过逻辑回归模型计算了听力损失和中风的比值比。
随着听力损失程度的增加，中风的患病率风险逐渐增加。与正常听力相比，重度或更重度听力损失者在言语频率和高频时发生中风的风险分别增加了 76%和 39%。同样，重度或更重度听力损失者在言语频率和高频时发生缺血性中风的风险分别增加了 69%和 52%；而在言语频率时，重度或更重度听力损失与正常听力相比，发生出血性中风的风险增加了约 2 倍。分层分析表明，一些心血管疾病高危参与者，如男性、年龄≥65 岁、接触职业噪音、吸烟者、患有糖尿病、高血压或高血脂症，中风风险更高。此外，重度或更重度听力损失与年龄、糖尿病、高血压和高血脂症联合作用对中风有影响。
这些结果表明，听力损失与中老年人群中风风险之间存在剂量反应关系。
