Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
J Am Geriatr Soc. 2021 Nov;69(11):3103-3113. doi: 10.1111/jgs.17275. Epub 2021 May 24.
Osteoporosis and low bone density (LBD) may be associated with higher risk of hearing loss, but findings are inconsistent and longitudinal data are scarce. Bisphosphonates may influence risk, but the relation has not been studied in humans. We longitudinally investigated associations of osteoporosis and LBD, bisphosphonate use, vertebral fracture (VF), hip fracture (HF), and risk of self-reported moderate or worse hearing loss.
Longitudinal cohort study.
The Nurses' Health Study (NHS) (1982-2016) and Nurses' Health Study II (NHS II) (1995-2017).
Participants included 60,821 NHS women, aged 36-61 years at baseline, and 83,078 NHS II women, aged 31-48 years at baseline (total n = 143,899).
Information on osteoporosis, LBD, bisphosphonate use, VF, HF, and hearing status was obtained from validated biennial questionnaires. In a subcohort (n = 3749), objective hearing thresholds were obtained by audiometry. Multivariable-adjusted Cox proportional hazards models were used to examine independent associations between osteoporosis (NHS), osteoporosis/LBD (NHS II), and risk of hearing loss.
The multivariable-adjusted relative risk (MVRR, 95% confidence interval) of moderate or worse hearing loss was higher among women with osteoporosis or LBD in both cohorts. In NHS, compared with women without osteoporosis, the MVRR was 1.14 (1.09, 1.19) among women with osteoporosis; in NHS II, the MVRR was 1.30 (1.21, 1.40) among women with osteoporosis/LBD. The magnitude of the elevated risk was similar among women who did and did not use bisphosphonates. VF was associated with higher risk (NHS: 1.31 [1.16, 1.49]; NHS II: 1.39 [1.13, 1.71]), but HF was not (NHS: 1.00 [0.86, 1.16];NHS II: 1.15 [0.75,1.74]). Among participants with audiometric measurements, compared with women without osteoporosis/LBD, the mean multivariable-adjusted hearing thresholds were higher (i.e., worse) among those with osteoporosis/LBD who used bisphosphonates.
Osteoporosis and LBD may be important contributors to aging-related hearing loss. Among women with osteoporosis, the risk of hearing loss was not influenced by bisphosphonate use.
骨质疏松症和低骨密度（LBD）可能与更高的听力损失风险相关，但研究结果并不一致，且缺乏纵向数据。双膦酸盐可能会影响风险，但在人类中尚未对此进行研究。我们进行了一项纵向研究，调查了骨质疏松症和 LBD、双膦酸盐使用、椎体骨折（VF）、髋部骨折（HF）与自报中度或更严重听力损失风险之间的关联。
纵向队列研究。
护士健康研究（NHS）（1982-2016 年）和护士健康研究 II（NHS II）（1995-2017 年）。
NHS 研究包括 60821 名年龄为 36-61 岁的女性，NHS II 研究包括 83078 名年龄为 31-48 岁的女性（总人数为 143899 人）。
通过经过验证的每两年一次的问卷获取骨质疏松症、LBD、双膦酸盐使用、VF、HF 和听力状况的信息。在一个亚队列（n=3749）中，通过听力计获得客观听力阈值。多变量调整的 Cox 比例风险模型用于检查骨质疏松症（NHS）、骨质疏松症/LBD（NHS II）与听力损失风险之间的独立关联。
在两个队列中，患有骨质疏松症或 LBD 的女性发生中度或更严重听力损失的多变量调整相对风险（MVRR，95%置信区间）均较高。与没有骨质疏松症的女性相比，NHS 中患有骨质疏松症的女性的 MVRR 为 1.14（1.09，1.19）；NHS II 中患有骨质疏松症/LBD 的女性的 MVRR 为 1.30（1.21，1.40）。在使用和不使用双膦酸盐的女性中，风险升高的幅度相似。VF 与更高的风险相关（NHS：1.31[1.16，1.49]；NHS II：1.39[1.13，1.71]），但 HF 无相关性（NHS：1.00[0.86，1.16]；NHS II：1.15[0.75，1.74]）。在有听力测量值的参与者中，与没有骨质疏松症/LBD 的女性相比，使用双膦酸盐的骨质疏松症/LBD 女性的平均多变量调整听力阈值更高（即更差）。
骨质疏松症和 LBD 可能是与衰老相关听力损失的重要因素。在患有骨质疏松症的女性中，听力损失的风险不受双膦酸盐使用的影响。
