Wang Tang-Chuan, Chang Ta-Yuan, Salvi Richard, Juan Chun-Jung, Liu Yi-Wen, Chang Chia-Hao, Chiu Chien-Jen, Lin Chia-Der, Tsai Ming-Hsui
Department of Public Health, College of Public Health.
School of Medicine, College of Medicine, China Medical University, Taichung.
Medicine (Baltimore). 2020 Mar;99(11):e19284. doi: 10.1097/MD.0000000000019284.
High levels of albuminuria have been demonstrated to associate with hearing loss in non-diabetic people, while the clinical impact of low-grade albuminuria has attracted less attention. This cross-sectional population-based study aimed to examine whether hearing loss in non-diabetic United States (US) adults is independently associated with low-grade albuminuria or reduced estimated glomeruli filtration rate (eGFR).A total of 2518 participants aged 20 to 69 years were selected from the US National Health and Nutritional Examination Survey database. Participants with diabetes or high-grade albuminuria were excluded. Hearing loss was assessed using low-frequency pure-tone average (LFPTA) thresholds (0.5, 1.0, 2.0 kHz) and high-frequency pure-tone average (HFPTA) thresholds (3.0, 4.0, 6.0, 8.0 kHz). Logistic and linear regression analyses were used to evaluate associations between renal function indicators and hearing loss.The median age of included participants was 37.4 years, and 55% of them were female. Multivariate analysis revealed that participants with urinary albumin-to-creatinine ratio (UACR) in the highest tertile had a significantly higher risk of hearing loss (OR, 1.79; 95% CI, 1.01-3.19) and higher HFPTA thresholds (β: 2.23; SE: 0.77). Participants with eGFR <60 mL/min/1.73 m had higher LFPTA thresholds (β: 4.31; SE: 1.79). After stratification by sex, a significant risk remained only for males in the highest UACR tertile, with 2.18 times the risk of hearing loss (95% CI, 1.06-4.48).Non-diabetic US males with low-grade albuminuria are at increased risk of hearing loss, independent of eGFR.
已有研究表明,在非糖尿病患者中,高水平蛋白尿与听力损失有关,而低度蛋白尿的临床影响则较少受到关注。这项基于人群的横断面研究旨在探讨美国非糖尿病成年人的听力损失是否与低度蛋白尿或估计肾小球滤过率(eGFR)降低独立相关。
从美国国家健康与营养检查调查数据库中选取了2518名年龄在20至69岁之间的参与者。排除患有糖尿病或高度蛋白尿的参与者。使用低频纯音平均(LFPTA)阈值(0.5、1.0、2.0kHz)和高频纯音平均(HFPTA)阈值(3.0、4.0、6.0、8.0kHz)评估听力损失。采用逻辑回归和线性回归分析来评估肾功能指标与听力损失之间的关联。
纳入参与者的中位年龄为37.4岁,其中55%为女性。多变量分析显示,尿白蛋白与肌酐比值(UACR)处于最高三分位数的参与者听力损失风险显著更高(OR,1.79;95%CI,1.01 - 3.19),且HFPTA阈值更高(β:2.23;SE:0.77)。eGFR<60mL/min/1.73m²的参与者LFPTA阈值更高(β:4.31;SE:1.79)。按性别分层后,仅UACR最高三分位数的男性存在显著风险,听力损失风险是其他人的2.18倍(95%CI,1.06 - 4.48)。
美国非糖尿病男性中,低度蛋白尿患者听力损失风险增加,且独立于eGFR。