Baiduc Rachael R, Bogle Brittany, Gonzalez Ii Franklyn, Dinces Elizabeth, Lee David J, Daviglus Martha L, Dhar Sumitrajit, Cai Jianwen
Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, Colorado.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
J Am Acad Audiol. 2022 Oct;33(9-10):445-459. doi: 10.1055/s-0042-1758529. Epub 2024 Sep 13.
Individual cardiovascular disease (CVD) risk factors (RFs) have been associated with hearing loss (HL). The relationship to aggregate risk is poorly understood and has not been explored in the Hispanic/Latino population.
The aim of this study was to characterize the association between aggregate CVD RF burden and hearing among Hispanics/Latinos.
Cross-sectional examination.
Participants (18-74 years; = 12,766) in the Hispanic Community Health Study/Study of Latinos.
Thresholds (0.5-8 kHz) were obtained, and HL was defined dichotomously as pure-tone average (PTA) > 25 dB HL. Optimal CVD risk burden was defined as follows: systolic blood pressure (SBP) < 120 mm Hg and diastolic blood pressure (DBP) < 80 mm Hg; total cholesterol < 180 mg/dL; nonsmoking; and no diabetes. Major CVD RFs were diabetes, currently smoking, SBP >160 or DBP > 100 mm Hg (or antihypertensives), and total cholesterol > 240 mg/dL (or statins). Thresholds were estimated by age (18-44 and ≥45 years) and sex using linear regression. The association between CVD risk burden and HL was assessed using multivariable logistic regression. Models were adjusted for age, sex, Hispanic/Latino background, center, education, income, alcohol use, body mass index, and noise exposure.
In the target population, 53.03% were female and 18.81% and 8.52% had all RFs optimal and ≥2 major RFs, respectively. Elevated BP (SBP 120-139 mm Hg or DBP 80-89 mm Hg) was associated with HL in females < 45 years (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.14-4.16). Diabetes (OR, 1.37; 95% CI, 1.01-1.84) and tobacco smoking (OR, 1.44; 95% CI, 1.03-2.01) were associated with HL in females ≥ 45 years. The odds of HL were higher for females ≥ 45 years with ≥2 RFs versus those with all RFs optimal (OR, 1.99; 95% CI, 1.12-3.53). Elevated BP (SBP 140-159 mm Hg or DBP 90-99 mm Hg), but not aggregate risk burden, was associated with HL in males ≥ 45 years (OR, 1.49; 95% CI, 1.02-2.19). No relationships with major CVD RFs were significant in males < 45 years.
HL is associated with elevated BP in females < 45 years, with diabetes and hypertension in males ≥ 45 years, and with diabetes, smoking, and having ≥2 major CVD RFs in females ≥ 45 years. Future studies are needed to examine if these factors are associated with incident HL.
个体心血管疾病（CVD）危险因素（RFs）与听力损失（HL）相关。与综合风险的关系了解甚少，且尚未在西班牙裔/拉丁裔人群中进行探索。
本研究的目的是描述西班牙裔/拉丁裔人群中CVD综合RF负担与听力之间的关联。
横断面检查。
西班牙裔社区健康研究/拉丁裔研究中的参与者（18 - 74岁；n = 12766）。
获取听阈（0.5 - 8kHz），HL二分法定义为纯音平均听阈（PTA）> 25dB HL。最佳CVD风险负担定义如下：收缩压（SBP）< 120mmHg且舒张压（DBP）< 80mmHg；总胆固醇< 180mg/dL；不吸烟；无糖尿病。主要CVD RFs为糖尿病、当前吸烟、SBP > 160或DBP > 100mmHg（或服用降压药）以及总胆固醇> 240mg/dL（或服用他汀类药物）。听阈按年龄（18 - 44岁和≥45岁）和性别通过线性回归进行估计。使用多变量逻辑回归评估CVD风险负担与HL之间的关联。模型针对年龄、性别、西班牙裔/拉丁裔背景、中心、教育程度、收入、饮酒情况、体重指数和噪声暴露进行了调整。
在目标人群中；53.03%为女性，分别有18.81%和8.52%的人所有RFs均最佳以及有≥2个主要RFs。血压升高（SBP 120 - 139mmHg或DBP 80 - 89mmHg）与< 45岁女性的HL相关（优势比[OR]，2.18；95%置信区间[CI]，1.14 - 4.16）。糖尿病（OR，1.37；95% CI，1.01 - 1.84）和吸烟（OR，1.44；95% CI，1.03 - 2.01）与≥45岁女性的HL相关。≥45岁且有≥2个RFs的女性发生HL的几率高于所有RFs均最佳的女性（OR，1.99；95% CI，1.12 - 3.53）。血压升高（SBP 140 - 159mmHg或DBP 90 - 99mmHg）而非综合风险负担与≥45岁男性的HL相关（OR，1.49；95% CI，1.02 - 2.19）。在< 45岁男性中，与主要CVD RFs无显著关系。
HL与< 45岁女性的血压升高、≥45岁男性的糖尿病和高血压以及≥45岁女性的糖尿病、吸烟和有≥2个主要CVD RFs相关。未来需要进行研究以检验这些因素是否与新发HL相关。
