Long Lili, Jia Zhenchao, Liu Tao
Department of Otorhinolaryngology, Sichuan University Hospital of Sichuan University, Chengdu, China.
Department of Prevention and Health Care, Sichuan University Hospital of Sichuan University, Chengdu, China.
Front Public Health. 2024 Dec 18;12:1431122. doi: 10.3389/fpubh.2024.1431122. eCollection 2024.
Hearing loss (HL) is a common sensory disorder in humans. Studies on the relationship between arsenic, which is a highly toxic and widely distributed heavy metal with a health risk to humans, and hearing status in humans are contradictory and mostly focused on people living in arsenic-contaminated areas. This study investigated the association between urinary arsenic levels and hearing threshold shifts in the general population in the United States.
Overall, 1,017 adults (aged 20-69 years) from the National Health and Nutrition Examination Survey (2015-2016) were included in this study. HL was defined as pure-tone average (PTA) ≥ 20 dB at frequencies 500, 1,000, 2000, and 4,000 Hz in the better-hearing ear. Total urinary arsenic (uAs) and dimethylarsinic acid (uDMA) levels were analyzed. Multivariate linear regression analyses and smooth curve fitting were performed to evaluate the correlations between uDMA, uAs, and low-, speech-, and high-frequency hearing levels.
The mean age of the participants was 42.13 ± 13.66 years, including weighted 48.67% men and 12.88% participants with sensorineural HL. After adjusting for potential confounders in the multivariate linear regression model, higher uDMA levels were significantly associated with poor low-, and speech-frequency PTAs, with no differences among participants by age or sex. Smooth curve fitting indicated a nonlinear relationship between uAs and high-frequency PTA hearing threshold shifts. The uAs levels were positively associated with high-frequency PTA until the turning point of 1.54 (adjusted 4.53, 95% CI 1.16, 7.90; = 0.0085), beyond which this association was not observed (adjusted β -0.43, 95% CI -1.57, 0.71; = 0.4600).
We found positive associations between urinary arsenic metabolites uDMA, uAs levels and poor hearing threshold shifts in US adults. This study provides new evidence for the association between arsenic exposure and auditory function.
听力损失（HL）是人类常见的感觉障碍。砷是一种剧毒且广泛分布的重金属，对人类健康有风险，关于砷与人类听力状况之间关系的研究结果相互矛盾，且大多集中在生活在砷污染地区的人群。本研究调查了美国普通人群尿砷水平与听力阈值变化之间的关联。
本研究纳入了来自国家健康与营养检查调查（2015 - 2016年）的1017名成年人（年龄在20 - 69岁之间）。HL被定义为较好耳在500、1000、2000和4000赫兹频率处的纯音平均听阈（PTA）≥20分贝。分析了总尿砷（uAs）和二甲基砷酸（uDMA）水平。进行多变量线性回归分析和平滑曲线拟合，以评估uDMA、uAs与低、言语和高频听力水平之间的相关性。
参与者的平均年龄为42.13±13.66岁，其中加权男性占48.67%，感音神经性HL参与者占12.88%。在多变量线性回归模型中对潜在混杂因素进行调整后，较高的uDMA水平与较差的低和言语频率PTA显著相关，参与者之间在年龄或性别方面无差异。平滑曲线拟合表明uAs与高频PTA听力阈值变化之间存在非线性关系。在转折点1.54之前，uAs水平与高频PTA呈正相关（调整后β = 4.53，95%可信区间1.16，7.90；P = 0.0085），超过该点则未观察到这种关联（调整后β = -0.43，95%可信区间-1.57，0.71；P = 0.4600）。
我们发现美国成年人尿砷代谢产物uDMA、uAs水平与较差的听力阈值变化之间存在正相关。本研究为砷暴露与听觉功能之间的关联提供了新证据。
