Association between hearing loss and gout based on National Health and Nutrition Examination Survey and Mendelian randomization analysis.

Hearing loss(HL) represents a significant public health concern. This study aimed to determine the association between hearing loss and gout and to elucidate the underlying causative mechanisms. Data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) and Mendelian randomization (MR) basic databases. Initially, baseline characteristics of individuals with and without gout were compared. A nonlinear relationship between pure tone audiometry (PTA) values and gout prevalence was confirmed through restricted cubic spline (RCS) curve analysis. Subsequently, hearing loss was categorized into different levels based on PTA values, and multiple logistic regression analysis was employed to calculate the impact of varying degrees of hearing loss on the risk of gout. Finally, MR analysis was conducted to further elucidate the causal relationship between hearing loss and gout. A total of 3,258 individuals were included in this study, with a gout prevalence of 3.7%. Significant differences were observed between the gout group and the non-gout group in variables such as age, gender, blood uric acid level, BMI, hypertension, and diabetes. RCS curve analysis revealed a significant nonlinear relationship between PTA values and gout risk, particularly when PTA values exceed a specific threshold, where the curve flattens. Based on different levels of hearing loss derived from PTA values, multiple logistic regression analysis demonstrated that mild and moderate hearing loss significantly increased the risk of gout, remaining statistically significant after adjusting for covariates (odds ratio (OR) = 2.10-3.48, P < 0.05). MR analysis further confirmed the causal relationship between hearing loss and gout. Inverse variance weighting (IVW) was employed as the primary method, revealing that both individuals with hearing difficulties (OR = 0.98, 95% confidence interval (CI) 0.96-0.999, P = 0.012) and those without hearing impairment (OR = 1.02, 95% CI 1.01-1.04, P = 0.012) exhibited a significant causal relationship with gout. Goodness-of-fit tests and sensitivity analyses were used to verify the reliability of the results. Hearing loss has a significant causal relationship with an increased risk of gout, providing a new perspective for the prevention and management of gout. Focused attention and prompt treatment of hearing loss, particularly mild and moderate hearing loss, may significantly reduce the risk of developing gout.