Article

Obesity and risk of hearing loss: A prospective cohort study

March 2019
Clinical Nutrition 39(3)

DOI:10.1016/j.clnu.2019.03.020

Authors:

Huan Hu

Keisuke Kuwahara

Yokohama City University

Makoto Yamamoto

YAMAHA Health Care Center

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Background & aims: The existing yet limited prospective studies reported conflicting results about obesity and hearing loss. We investigated the prospective association between obesity and hearing loss in a large-scale Japanese working population, as well as the association between metabolic phenotype and hearing loss. Methods: The study included 48,549 employees aged 20-64 years and free of hearing loss at baseline. Pure-tone audiometric testing was performed annually to identify hearing loss at 1 and 4 kHz. Cox proportional hazards regression was used to investigate the risk of hearing loss associated with body mass index (BMI) and metabolic phenotype (based on a BMI of ≥25.0/<25.0 kg/m2 and presence/absence of ≥2 components of metabolic syndrome, except waist circumference). Baseline and updated information were obtained from annual health checkups. Results: With a median follow-up of 7 years, 1595 and 3625 individuals developed unilateral hearing loss at 1 and 4 kHz, respectively. The adjusted hazard ratios (HR) for hearing loss at 1 kHz were 1.21 (1.08, 1.36) and 1.66 (1.33, 2.08) for those with BMI 25.0-29.9 kg/m2 and BMI ≥30.0 kg/m2, respectively, compared to individuals with BMI <25.0 kg/m2. For hearing loss at 4 kHz, the corresponding HRs were 1.14 (1.05, 1.23) and 1.29 (1.09, 1.52). Compared with metabolically healthy non-obese individuals, the adjusted HRs for hearing loss at 1 kHz were 1.19 (1.03, 1.39), 1.27 (1.01, 1.61), and 1.48 (1.25, 1.76) for unhealthy non-obese, healthy obese, and unhealthy obese individuals, respectively. For hearing loss at 4 kHz, the corresponding HRs were 1.13 (1.04, 1.25), 1.21 (1.04, 1.41), and 1.26 (1.12, 1.41). Conclusions: Overweight and obesity are associated with an increased risk of hearing loss, and metabolically unhealthy obesity may confer additional risk.

Obesity and risk of hearing loss in the middle-aged and elderly: a national cohort of Chinese adults

Article

Full-text available

Jun 2023
BMC PUBLIC HEALTH

Background The relationship between obesity and hearing loss among the middle-aged and older population remained unclear. Moreover, few studies have focused on the impact of gender on this association. Methods This cohort study extracted the data from the China Health and Retirement Longitudinal Study, a national survey of adults aged 45 years or over. Waist circumference was categorized into three groups: normal, pre-central obesity, and central obesity. We classified BMI into four categories: underweight, normal weight, overweight, and obese. The primary endpoint was the incidence of self-reported hearing loss. Results Of the 14,237 participants, 1972 incidents of hearing loss were identified during a median 6.9 years of follow-up. The cumulative incidence of hearing loss was 13.9% (95% CI 13.3% -14.4%). Our study showed that central obesity was significantly associated with hearing loss (HR 0.84, 95%CI 0.75–0.94), and this relationship was more prominent in males (HR 0.76, 95%CI 0.63–0.91). Among male participants, the underweight group was at the highest risk of hearing loss (HR 1.39, 95%CI 1.08–1.79). Compared with the normal weight group, the adjusted HR for hearing loss in the obese groups was 0.69 (95%CI 0.51–0.94) among men. Among female participants, only the overweight group had a lower risk of hearing loss than the normal weight group (HR 0.83, 95%CI 0.71–0.96). Conclusions Being overweight and obese were significantly associated with a decreased risk of hearing loss, whereas being underweight was associated with an increased risk of hearing loss.

The Link between Gut Dysbiosis Caused by a High-Fat Diet and Hearing Loss

Article

Full-text available

Dec 2021
INT J MOL SCI

This review aims to provide a conceptual and theoretical overview of the association between gut dysbiosis and hearing loss. Hearing loss is a global health issue; the World Health Organisation (WHO) estimates that 2.5 billion people will be living with some degree of hearing loss by 2050. The aetiology of sensorineural hearing loss (SNHL) is complex and multifactorial, arising from congenital and acquired causes. Recent evidence suggests that impaired gut health may also be a risk factor for SNHL. Inflammatory bowel disease (IBD), type 2 diabetes, diet-induced obesity (DIO), and high-fat diet (HFD) all show links to hearing loss. Previous studies have shown that a HFD can result in microangiopathy, impaired insulin signalling, and oxidative stress in the inner ear. A HFD can also induce pathological shifts in gut microbiota and affect intestinal barrier (IB) integrity, leading to a leaky gut. A leaky gut can result in chronic systemic inflammation, which may affect extraintestinal organs. Here, we postulate that changes in gut microbiota resulting from a chronic HFD and DIO may cause a systemic inflammatory response that can compromise the permeability of the blood–labyrinth barrier (BLB) in the inner ear, thus inducing cochlear inflammation and hearing deficits.

The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss

Article

Full-text available

Jul 2024

Introduction Sudden sensorineural hearing loss (SSNHL) is a common emergency symptom in otolaryngology that requires immediate diagnosis and treatment. SSNHL has a multifactorial etiology, and its pathophysiologic mechanisms may be associated with inflammatory and metabolic changes that may affect the cochlear microenvironment or its nervous component, thus triggering the process or hindering hearing recovery. Therefore, the aim of this study was to assess metabolic and inflammatory changes to identify systemic parameters that could serve as prognostic factors for hearing recovery in patients with SSNHL. Materials and methods Thirty patients with a sudden hearing loss of at least 30 dB in three contiguous frequencies were enrolled in this study. Patients were followed up for 4 months and peripheral blood samples were collected at 7 days (V1), 30 days (V2) and 120 days (V3). Interleukins (IL)-1F7, IL-2, IL-4, IL-5, IL-6, IL-10, interferon γ (IFN-γ), tumor necrosis factor α (TNF-α) and adiponectin were quantified in serum. In addition, lipid and glycemic profiles as well as concentration of creatinine, uric acid, fructosamine, peroxide, total proteins and albumin were analyzed. Patients underwent weekly ear-specific hearing tests with standard pure tone thresholds for frequencies of 250–8,000 Hz, speech recognition threshold and word recognition score. Results Patients with SSNHL were divided into a group of patients who did not achieve hearing recovery (n = 14) and another group who achieved complete and significant recovery (n = 16). Most serologic parameters showed no significant changes or values indicating clinical changes. However, IFN-γ levels decreased by 36.3% between V1 and V2. The cytokine TNF-α showed a statistically significant decrease from V1 to V3 (from 22.91 to 10.34 pg./mL). Adiponectin showed a decrease from 553.7 ng/mL in V1 to 454.4 ng/mL in V3. Discussion Our results show that serologic cytokine levels change in the acute phase of manifestation of SSNHL and establish a parallel between systemic changes and improvements in hearing, especially TNF-α, which showed differences in hearing recovery. The use of IFN-γ, TNF-α and adiponectin may elucidate the clinical improvement in these patients.

Association of conventional cigarette smoking, heated tobacco product use, and dual use with hearing loss: A working population-based study

Article

Full-text available

May 2024

INTRODUCTION Although conventional cigarette smoking has been linked to an increased risk of hearing loss, the association between heated tobacco products (HTPs) and hearing loss is unknown. The objective of this study was to investigate the association between cigarette and HTP use and hearing loss. METHODS This cross-sectional study examined the data of 7769 employees from five companies (Study I) and 34404 employees from a large company (Study II), all participants in the Japan Epidemiology Collaboration on Occupational Health Study. The participants were categorized into five groups based on their self-reported tobacco use: never smokers, former smokers, exclusive cigarette smokers, exclusive users of HTPs, and those who used both cigarettes and HTPs. Hearing levels were measured using pure-tone audiometry at 1 and 4 kHz frequencies. Separate analyses were carried out for each study, and the results were then combined using fixed-effect models to pool the estimates. RESULTS The analysis included 42173 participants, with a prevalence of 12.9% for exclusive cigarette smoking, 9.8% for exclusive HTP use, and 5.5% for dual use. The pooled adjusted odds ratios with 95% confidence intervals for unilateral hearing loss at 4 kHz were 1.21 (95% CI: 1.10–1.33) for former smokers, 1.83 (95% CI: 1.64–2.05) for exclusive cigarette smokers,1.46 (95% CI: 1.28–1.67) for exclusive HTP users, and 1.66 (95% CI: 1.41–1.96) for dual users, compared to never smokers. Additionally, the adjusted odds ratios for hearing loss at 4 kHz among exclusive cigarette smokers, exclusive HTP users, and dual users increased with the intensity of cigarette/HTP consumption (all p for trend <0.001). No significant associations were found between exclusive HTP use, dual use, and hearing loss at 1 kHz, apart from exclusive cigarette smoking. CONCLUSIONS In this cross-sectional study, associations were found between exclusive cigarette smoking, exclusive HTP use, dual use, and hearing loss, particularly at 4 kHz. Further research is needed to confirm these findings.

Utilizing Artificial Neural Networks for Establishing Hearing-Loss Predicting Models Based on a Longitudinal Dataset and Their Implications for Managing the Hearing Conservation Program

Article

Full-text available

Feb 2024

Background Though the artificial neural network (ANN) technique has been used to predict noise-induced hearing loss (NIHL), the established prediction models have primarily relied on cross-sectional datasets, and hence, they may not comprehensively capture the chronic nature of NIHL as a disease linked to long-term noise exposure among workers. Methods A comprehensive dataset was utilized, encompassing eight-year longitudinal personal hearing threshold levels (HTLs) as well as information on seven personal variables and two environmental variables to establish NIHL predicting models through the ANN technique. Three subdatasets were extracted from the afirementioned comprehensive dataset to assess the advantages of the present study in NIHL predictions. Results The dataset was gathered from 170 workers employed in a steel-making industry, with a median cumulative noise exposure and HTL of 88.40 dBA-year and 19.58 dB, respectively. Utilizing the longitudinal dataset demonstrated superior prediction capabilities compared to cross-sectional datasets. Incorporating the more comprehensive dataset led to improved NIHL predictions, particularly when considering variables such as noise pattern and use of personal protective equipment. Despite fluctuations observed in the measured HTLs, the ANN predicting models consistently revealed a discernible trend. Conclusions A consistent correlation was observed between the measured HTLs and the results obtained from the predicting models. However, it is essential to exercise caution when utilizing the model-predicted NIHLs for individual workers due to inherent personal fluctuations in HTLs. Nonetheless, these ANN models can serve as a valuable reference for the industry in effectively managing its hearing conservation program.

The Impact of Cigarette Smoking, Water-Pipe Use on Hearing Loss/Hearing Impairment: A Cross-Sectional Study

Article

Full-text available

Jan 2024

Objective: The aim of the present study was to determine the association between cigarette smoking, waterpipe smoking, and co-morbidity diseases on hearing loss. Methods: A cross-sectional study was conducted among 1015 patients [386 males (38%) and 629 females (62%)] who were aged are between 25 and 65 years. The study used clinical, physical examinations and Pure-Tone Audiometry (PTA) to assess hearing. Univariate and multivariate stepwise logistic regression analyses were used for the statistical analysis. Results: Out of 1015 patients assessed, 199 were cigarette smokers with hearing loss (21.6%) and 111 waterpipe smokers with hearing loss (12%). There were statistically significant differences between cigarette smokers with hearing loss regarding (p<0.001), gender (p<0.001), BMI (p<0.001), hypertension (p<0.001), tinnitus (p<0.001), vertigo and/or dizziness (p<0.001), and migraine/headaches (p<0.001). Also there were statistically significant differences between waterpipe smokers with hearing loss, none smokers concerning age groups (p<0.001), BMI (p<0.001), using MP3 players (p=0.004), family history of hypertension (p=0.026), ATP III metabolic syndrome (p=0.010), IDF metabolic syndrome (p=0.012), tinnitus (p<0.001), vertigo/dizziness (p<0.001), and migraine/headaches (p=0.025). Multivariate stepwise logistic regression analysis indicated that tinnitus (p<0.001), dizziness (p<0.001), nausea (p=0.001), headaches and migraine (p<=0.003), fatigue (p=0.004), and vertigo (p=0.022) were considered as risk predictors risk hearing loss related cigarette smokers. Also, analysis revealed that tinnitus (p<0.001), nausea (p=0.001), headaches and migraines (p<0.001), Type 2 diabetes mellitus (p<0.001), and vertigo (p=0.021), were considered as risk predictors for hearing loss related waterpipe smokers. Conclusion: The present study suggests cigarette smoking and waterpipe smoking, life-style factors are possible risk factors for hearing loss among smoker participants.

Prevalence and risk factors of self-reported audiovestibular symptoms in a population-based sample from rural northeastern Germany

Preprint

Full-text available

Aug 2023

Objectives. The senses of hearing and balance are linked by a close anatomical and physiological relationship. A further pathophysiological interaction is supposed but the detailed mechanism and direction remains elusive. Further insight is required into the prevalence of the audiovestibular symptoms hearing loss, tinnitus and dizziness as only scarce information on the combined occurrence is available so far. Therefore, this was assessed in a population-based sample. Based on this, we studied the influence of risk factors from lifestyle habits as well as cardiovascular and metabolic conditions on the development of audiovestibular symptoms alone and in combination. Design. This analysis evaluated the prevalence of self-reported hearing loss, tinnitus and dizziness in two separate population-based samples from West Pomerania, a rural region of north-eastern Germany. Datasets from 8134 individuals aged 20 to 79 years were available from the baseline investigations of the cohorts START and TREND of the Study of Health in Pomerania (SHIP). Audiovestibular symptoms were assessed by structured questionnaires. The cohorts were comprehensively characterized regarding modifiable lifestyle factors as well as cardiovascular and metabolic disorders, allowing the assessment of the role of those influencing factors. Results. Audiovestibular symptoms were prevalent and overlapping in the investigated population. 2350 individuals (28.9%) reported at least one, 648 (8.1%) two and 111 (1.4%) all three audiovestibular symptoms. Thereby, we observed a weighted prevalence of 14.2% for hearing loss, 9.7% for tinnitus and 13.5% for dizziness in the population. The prevalences increased with age and differed among the sexes. The prevalence of hearing loss as well as tinnitus increased between the two cohorts. A moderate positive correlation was found between hearing loss and tinnitus (phi-coefficient 0.318). In multivariable regression analyses, only smoking was significantly associated with all three symptoms. Less education and several cardiovascular risk factors contributed to both hearing loss and dizziness. Conclusions. Audiovestibular symptoms are highly prevalent in the general population and the occurrence overlaps. A considerable but complex influence of risk factors points towards a relation with neuronal as well as cardiovascular disease processes. Future studies should identify subgroups that are particularly at risk. Additionally, to clarify the underlying mechanisms the interaction between the senses of hearing and balance as well as the mode of action of the risk factors should be evaluated in more detail in the future.

Cardiocerebrovascular risk in sensorineural hearing loss: results from the National Health and Nutrition Examination Survey 2015 to 2018

Article

Full-text available

Jul 2023

Objective This study aims to determine whether the risks of cardiocerebrovascular disease are relevant to sensorineural hearing loss (SNHL) based on a national database. Methods A total of 1,321 participants aged from 18 to 69 with complete data including medical history and audiometry from the NHANES database (2015–2018) were analyzed. All included participants had available hearing data and the average thresholds of the hearing data were measured and calculated as low-frequency pure-tone average (LFPTA; 500, 1,000, and 2,000 Hz) and high-frequency pure-tone average (HFPTA; 3,000, 4,000, 6,000, and 8,000 kHz). SNHL was defined as an average pure tone of more than or equal to 20 dB in at least one better ear. Multivariable models to assess the association between cardiocerebrovascular risks and SNHL were used in this study. Results The prevalence of stroke was 1.6% in individuals with SNHL and 0.4% in individuals without SNHL (p = 0.023). A higher cardiovascular risk score was observed in SNHL patients compared to participants without SNHL (1.58 vs. 0.90, p < 0.001). Stroke was associated with a 3.67-fold increase in the risk of SNHL (95% CI: 1.12–12.00, p = 0.032) in univariable logistic regression, and the association (OR = 4.22, 95%CI = 1.28–13.93, p = 0.020) remained significant after adjusting for several covariates. Multivariable logistic regression models indicated a positive correlation between cardiovascular risk and SNHL (OR = 1.66, 95% CI = 1.40–1.96, p < 0.001), but no significant relationship was shown with all covariates adjusted. However, significant associations were found between SNHL and both age and sex in both univariable and multivariable logistic regression models. Conclusion Our findings suggested that a higher cardiocerebrovascular risk burden was associated with an increased risk of SNHL, and the relationship may be influenced by age and sex. Future longitudinal studies are needed to investigate the mechanistic and pathologic vascular hypothesis of SNHL.

Towards precision medicine in bariatric surgery prescription

Article

Full-text available

May 2023
REV ENDOCR METAB DIS

Obesity is a complex, multifactorial and chronic disease. Bariatric surgery is a safe and effective treatment intervention for obesity and obesity-related diseases. However, weight loss after surgery can be highly heterogeneous and is not entirely predictable, particularly in the long-term after intervention. In this review, we present and discuss the available data on patient-related and procedure-related factors that were previously appointed as putative predictors of bariatric surgery outcomes. In addition, we present a critical appraisal of the available evidence on which factors could be taken into account when recommending and deciding which bariatric procedure to perform. Several patient-related features were identified as having a potential impact on weight loss after bariatric surgery, including age, gender, anthropometrics, obesity co-morbidities, eating behavior, genetic background, circulating biomarkers (microRNAs, metabolites and hormones), psychological and socioeconomic factors. However, none of these factors are sufficiently robust to be used as predictive factors. Overall, there is no doubt that before we long for precision medicine, there is the unmet need for a better understanding of the socio-biological drivers of weight gain, weight loss failure and weight-regain after bariatric interventions. Machine learning models targeting preoperative factors and effectiveness measurements of specific bariatric surgery interventions, would enable a more precise identification of the causal links between determinants of weight gain and weight loss. Artificial intelligence algorithms to be used in clinical practice to predict the response to bariatric surgery interventions could then be created, which would ultimately allow to move forward into precision medicine in bariatric surgery prescription.

The Combined Effect of Elevated Blood Pressure and Occupational Noise Exposure on Bilateral High-Frequency Hearing Loss: Evidence From a Large Sample Cross-sectional Study

Article

Full-text available

Jan 2023
J OCCUP ENVIRON MED

Background: Combined effect of elevated blood pressure and occupational noise exposure on hearing loss has rarely been evaluated among Chinese population. Methods: This cross-sectional study was conducted in 242,811 participants. Logistic regression model was performed to estimate the independent and combined associations. Results: Compared with participants without occupational noise exposure, the risk of bilateral high-frequency hearing loss (BHFHL) was significantly higher for noise exposure ≥10 years (OR = 1.29, 95%CI = 1.23-1.35). Compared with no hypertension, participants with grade 1 hypertension had higher risk of BHFHL in all age groups (OR = 1.14, 95%CI = 1.09-1.20). As to the combined effect, the highest BHFHL risk was found in males (OR = 1.51, 95%CI = 1.37-1.67), especially among participants with grade 1 hypertension aged >50 (OR = 1.65, 95%CI = 1.46-1.88). Conclusions: Elevated blood pressure may synergistically influence hearing loss combined with occupational noise exposure.

Association of Metabolic Syndrome with Sensorineural Hearing Loss

Article

Full-text available

Oct 2021

The prevalence of sensorineural hearing loss has increased along with increases in life expectancy and exposure to noisy environments. Metabolic syndrome (MetS) is a cluster of co-occurring conditions that increase the risk of heart disease, stroke and type 2 diabetes, along with other conditions that affect the blood vessels. Components of MetS include insulin resistance, body weight, lipid concentration, blood pressure, and blood glucose concentration, as well as other features of insulin resistance such as microalbuminuria. MetS has become a major public health problem affecting 20-30% of the global population. This study utilized health examination to investigate whether metabolic syndrome was related to hearing loss. Methods: A total of 94,223 people who underwent health check-ups, including hearing tests, from January 2010 to December 2020 were evaluated. Subjects were divided into two groups, with and without metabolic syndrome. In addition, Scopus, Embase, PubMed, and Cochrane libraries were systematically searched, using keywords such as "hearing loss" and "metabolic syndrome", for studies that evaluated the relationship between the two. Results: Of the 94,223 subjects, 11,414 (12.1%) had metabolic syndrome and 82,809 did not. The mean ages of subjects in the two groups were 46.1 and 43.9 years, respectively. A comparison of hearing thresholds by age in subjects with and without metabolic syndrome showed that the average pure tone hearing thresholds were significantly higher in subjects with metabolic syndrome than in subjects without it in all age groups. (p < 0.001) Rates of hearing loss in subjects with 0, 1, 2, 3, 4, and 5 of the components of metabolic syndrome were 7.9%, 12.1%, 13.8%, 13.8%, 15.5% and 16.3%, respectively, indicating a significant association between the number of components of metabolic syndrome and the rate of hearing loss (p < 0.0001). The odds ratio of hearing loss was significantly higher in subjects with four components of metabolic syndrome: waist circumference, blood pressure, and triglyceride and fasting blood sugar concentrations (p < 0.0001). Conclusions: The number of components of the metabolic syndrome is positively correlated with the rate of sensorineural hearing loss.

A Prospective Cohort Study of Muscular and Performance Fitness and Risk of Hearing Loss: The Niigata Wellness Study

Article

Full-text available

Jul 2020
AM J MED

BACKGROUND Several cross-sectional studies have linked higher physical fitness with better hearing sensitivity but have not established a causal relation; none have used a prospective design that is less susceptible to bias. We used a prospective cohort study to investigate the association between muscular and performance fitness and the incidence of hearing loss. METHODS In total, 21,907 participants without hearing loss received physical fitness assessments between April 2001 and March 2002. Muscular and performance fitness index, an age- and sex-specific summed z-score based on grip strength, vertical jump height, single-leg balance, forward bending, and whole-body reaction time was calculated. Participants were classified into quartiles according to the muscular and performance fitness index as well as each physical fitness test. They were followed up for the development of hearing loss, assessed by pure-tone audiometry at annual health examinations between April 2002 and March 2008. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for hearing loss incidence were estimated using Cox proportional hazards regression models. RESULTS During follow-up, 2765 participants developed hearing loss. The HRs (95% CIs) for developing hearing loss across the muscular and performance fitness index quartiles (lowest to highest) were 1.00 (reference), 0.88 (0.79–0.97), 0.83 (0.75–0.93), and 0.79 (0.71–0.88) (Ptrend <.001). Among the various physical fitness components, a clear dose-response association with hearing loss incidence was observed in vertical jump height and single-leg balance (Ptrend <.001 for both). CONCLUSION Higher muscular and performance fitness is associated with a lower incidence of hearing loss.

A Critical Assessment of Occupational Noise Exposure and Relevant Variables for Hearing Disturbances: A Study among Watercraft Personnel

Article

Full-text available

Aug 2024

Noise pollution is one of the newly emerging environmental issues associated with ships. Despite numerous efforts to reduce noise, noise levels on board remain above the threshold limit value (TLV). The aims of present study were to classify levels of occupational noise, hearing disturbances, and identify other factors that impact hearing loss. From July to August 2022, this cross-sectional study was enrolled among speedboat members. We used sound level meter as a noise measurement, and audiometer for assessing hearing problems. The questionnaires were used to support the data with the questions according to age, job position, Body Mass Index (BMI), years of working, work duration in a day, smoking and alcohol consumption, physical activities, and hobbies during leisure time. Chi-Square test was used to find out the relationship between the variables. The captain's position does not exceed the TLV (average noise level was 85.45 dBA). In contrast, six speedboats in the crew's location exceeded TLV based on the length of exposure duration. A total of 109 participants (83.8%) had hearing loss, with the majority suffering from mild (40.8%), moderate (39.2%), and severe (3.8%) levels. Except for job position, all independent variables were related to hearing impairment. Due to prolonged exposure to noise, high decibel levels, and other factors, members of speedboats are susceptible to hearing loss. Age, BMI, and other lifestyle factors such as smoking, alcohol consumption, recreational activities, and daily exercise will also contribute to their hearing problem.

Relación entre síndrome metabólico, enfermedades metabólicas e hipoacusia: una revisión sistemática con metaanálisis. Association between Metabolic Syndrome and Risk of Hearing Loss: a Systematic Review and Meta-analysis

Article

Full-text available

Sep 2023
REV MED CHILE

Introduction: Various studies have linked lifestyle and metabolic diseases to hearing loss. Research on metabolic syndrome has reported a higher prevalence of hearing loss in individuals with it than those without it. Objectives: To conduct a systematic review and meta-analysis summarizing the risk of hearing loss in people diagnosed with metabolic syndrome or diseases versus those without metabolic syndrome. Methods. Following the PRISMA recommendations for systematic review and meta-analysis, searches were conducted in PubMed, Web of Science, and SciELO. Only cross-sectional studies associate hearing loss with obesity, hypertension, Diabetes, Dyslipidemia, Cholesterol, metabolic syndrome , and Hyperglycemia. The odds ratios (OR) with their 95% confidence intervals (CI) of the studies were pooled in a random effects model using the Mantel-Haenszel method. Using Rev Manager 5.1, OR heterogeneity was assessed using the I2 and Q statistics. Results. Twenty-eight observational studies were included in the quantitative analysis. The OR for prevalent hearing loss was 1.27 (95% CI 1.07, 1.51) in obesity, 1.97 (95% CI 1.51, 2.57) in diabetes, 1.53 (95% CI 1.31, 1.79) in hypertension, and 4.22 (95% CI 1.74, 10.20) for metabolic syndrome. Conclusions. The findings suggest that both metabolic syndrome and some diseases, such as obesity, diabetes, and hypertension, could be associated with the risk of hearing loss, and control of these diseases could reduce this risk. (Rev Med Chile 2023; 151: 1125-1142)

Online education and its relation to hearing status among higher-secondary students in Bangladesh: A cross-sectional survey

Preprint

Full-text available

Aug 2024

Background Online education gained its popularity in the education system during the COVID-19 pandemic lockdown. The online platform, including social media, was institutionalized globally for the purpose of tutoring to keep the education process ongoing under feasible circumstances. However, the post-pandemic continuation of online education and prolonged usage of electronic devices imposed a greater risk of health issues related to sensory impairment. Our study aimed to determine the impact of online education on students' hearing status and its associated factors. Methods A cross-sectional study was conducted among 1030 students of 11th grade and above who were undergoing online education in Dhaka and Chattogram. Data were collected through the online administration of a structured questionnaire containing questions on sociodemographic status, family history of diseases, personal history of comorbidities, information related to screentime exposure, and SSQ-12 (Speech, Spatial, and Qualities of Hearing -12) scale. Descriptive statistics, Pearson’s chi-square test, two independent sample t-tests, and multiple linear regression analysis were employed to obtain the results. Result The mean SSQ score of the study participants was 7.74±1.37. In bivariate analysis, gender, family income, family history of diseases (e.g., obesity, headache, hearing problem), personal history of diseases (e.g., obesity, insomnia), device type (mobile/tablet, computer), average daily screen time with sound, and break pattern during online learning were significantly (p<0.05 for all) associated with hearing status. In multivariate analysis, being female (coefficient -0.293, p=0.001), using mobile/tablet (coefficient -0.836, p=0.001), and continuous screen use (coefficient -0.348, p=0.003) were significantly associated with poor hearing status. Conclusion This current study indicates the detrimental effect of online education on the hearing of young students in Bangladesh. Future studies should explore the long-term hearing effects of online education and guide the policy makers towards incorporating online education with better approaches secondary to in-person classes.

Relación entre síndrome metabólico, enfermedades metabólicas e hipoacusia: una revisión sistemática con metaanálisis

Article

Full-text available

Sep 2023
REV MED CHILE

Objetivo: Realizar una revisión sistemática y metaanálisis que resuma el riesgo de hipoacusia de personas con diagnóstico de síndrome o enfermedades metabólicas versus aquellas sin síndrome metabólico. Material y Métodos: Siguiendo las recomendaciones PRISMA para revisión sistemática y metaanálisis, se realizaron búsquedas en 3 indexadores (PubMed, Web of Science y SciELO). Se incluyeron sólo estudios transversales que reportan asociaciones de hipoacusia con obesidad, Hipertensión; Diabetes, Dislipidemia, Colesterol, síndrome metabólico e Hiperglicemia. Las odds ratios (OR) con sus intervalos de confianza (IC) del 95% de los estudios se agruparon en un modelo de efectos aleatorios por el método de Mantel Haenszel. Con Rev Manager 5.1, se evaluó la heterogeneidad OR mediante las estadísticas I² y Q. Resultados: 28 estudios observacionales fueron incluidos en el análisis cuantitativo. Las OR para hipoacusia prevalente fue de 1.27 (95% IC 1.07, 1.51) en obesidad, 1.97 (95% IC 1.51, 2.57) en diabetes, 1.53 (95% IC 1.31, 1.79) en hipertensión y 4.22 (95% IC 1.74, 10.20) para síndrome metabólico. Conclusiones: Los hallazgos sugieren que tanto el síndrome metabólico como algunas enfermedades como obesidad, diabetes e hipertensión podrían asociarse con el riesgo de hipoacusia, pudiendo el control de estas enfermedades atenuar este riesgo.

Effects of cooking with solid fuel on hearing loss in Chinese adults—Based on two cohort studies

Article

Full-text available

May 2024

The association between cooking fuel and hearing loss still needs more research to clarify, and two longitudinal cohort studies were explored to find if solid fuel use for cooking affected hearing in Chinese adults. The data from Chinese Health and Retirement Longitudinal Survey (CHARLS) and Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed. Participants (older than 18) without hearing loss at baseline and follow-up visits were included, which were divided into clean fuel and solid fuel groups. Hearing loss rate was from follow-up visits (both in year 2011) until the recent one (year 2018 in CHARLS and 2019 in CLHLS). Cox regressions were applied to examine the associations with adjustment for potential confounders. Fixed-effect meta-analysis was used to pool the results. A total of 9049 participants (average age 8.34 ± 9.12 [mean ± SD] years; 4247 [46.93%] males) were included in CHARLS cohort study and 2265 participants (average age, 78.75 ± 9.23 [mean ± SD] years; 1148 [49.32%] males) in CLHLS cohort study. There were 1518 (16.78%) participants in CHARLS cohort and 451 (19.91%) participants in CLHLS cohort who developed hearing loss. The group of using solid fuel for cooking had a higher risk of hearing loss (CHARLS: HR, 1.16; 95% CI 1.03–1.30; CLHLS: HR, 1.43; 95% CI 1.11–1.84) compared with the one of using clean fuel. Pooled hazard ratio showed the incidence of hearing loss in the solid fuel users was 1.17 (1.03, 1.29) times higher than that of clean fuel users. Hearing loss was associated with solid fuel use and older people were at higher risk. It is advised to replace solid fuel by clean fuel that may promote health equity.

Sex differences in associated factors for age-related hearing loss

Article

Full-text available

Mar 2024
PLOS ONE

The prevalence and age of onset of hearing loss differ according to sex. This study aimed to identify associated factors for age-related hearing loss (ARHL) and determine whether there are differences between males and females regarding associated factors for ARHL. This cross-sectional study used data from adults who underwent medical examinations including hearing tests from 2011 to 2021. A total of 2,349 individuals were included. The study conducted sex-specific analyses using both univariate and multiple regression. Univariate analysis employed logistic regression, while multiple regression involved variable selection through the augmented backward elimination method. Separate multiple logistic regression analyses were conducted for each sex. In the univariate analysis, among males, age, underweight, alcohol consumption, weight, and height exhibited statistical significance. Among females, age, hypertension, diabetes, dyslipidemia, obesity, sarcopenia, weight, height, age at menarche, and duration of hormone exposure were found to be significant factors. However, in the multiple logistic regression model for males, underweight, and smoking emerged as significant, while in females, age, weight, obesity, and age at menarche retained their significance. We found that there are different associated factors for ARHL in each sex. Assessment and counseling for smoking, obstetric history, underweight, and obesity may be beneficial in managing patients with ARHL.

A bidirectional Mendelian randomisation study to evaluate the relationship between body constitution and hearing loss

Article

Full-text available

Oct 2023

Hearing loss and hearing disorders represent possible mediating pathways in the associations between noise exposures and non-auditory health outcomes. In this context, we assessed whether the noise-obesity associations should consider hearing functions as possible mediators and applied Mendelian randomisation (MR) to investigate causal relationships between body constitution and hearing impairments. We obtained genetic associations from publicly available summary statistics from genome-wide association studies in European ancestry adult populations (N= from 210,088 to 360,564) for (i) body constitution: body mass index (BMI), waist circumference (WC) and body fat percentage (BFP), and (ii) hearing loss: sensorineural hearing loss, noise-induced hearing loss, and age-related hearing impairment (ARHI). We employed colocalisation analysis to investigate the genetic associations for BMI and ARHI liability within an FTO locus. We conducted bi-directional MR for the ‘forward’ (from body constitution to hearing) and ‘reverse’ directions. We applied the random effects inverse variance-weighted method as the main MR method, with additional sensitivity analyses. Colocalisation analysis suggested that BMI and ARHI shared a causal variant at the FTO gene. We did not find robust evidence for causal associations from body constitution to hearing loss and suggested that some associations may be driven by FTO variants. In the reverse analyses, ARHI was negatively associated with BMI [effect size – 0.22 (95% CI – 0.44 to – 0.01)] and BFP [effect size – 0.23 (95% CI – 0.45 to 0.00)], supporting the notion that ARHI may diminish body constitution. Finally, our data suggest that there is no strong evidence that hearing explains the association between noise exposure and body constitution.

Independent and Combined Associations of Sleep Duration, Bedtime, and Polygenic Risk Score with the Risk of Hearing Loss among Middle-Aged and Old Chinese: The Dongfeng–Tongji Cohort Study

Article

Full-text available

Jun 2023

Evidence available on the independent and combined associations of sleep duration, bedtime, and genetic predisposition with hearing loss was lacking. The present study included 15,827 participants from the Dongfeng–Tongji cohort study. Genetic risk was characterized by polygenic risk score (PRS) based on 37 genetic loci related to hearing loss. We conducted multivariate logistic regression models to assess the odds ratio (OR) for hearing loss with sleep duration and bedtime, as well as the joint association and interaction with PRS. Results showed that hearing loss was independently associated with sleeping ≥9 h/night compared to the recommended 7 to 9:00 p.m. to 10:00 p.m. compared to those with bedtime >10:00 p.m. to 11:00 p.m., with estimated ORs of 1.25, 1.27, and 1.16, respectively. Meanwhile, the risk of hearing loss increased by 29% for each 5-risk allele increment of PRS. More importantly, joint analyses showed that the risk of hearing loss was 2-fold in sleep duration ≥9 h/night and high PRS, and 2.18-fold in bedtime ≤9:00 p.m. and high PRS. With significant joint effects of sleep duration and bedtime on hearing loss, we found an interaction of sleep duration with PRS in those with early bedtime and an interaction of bedtime with PRS in those with long sleep duration on hearing loss (Pint

Combined effects of multiple metals on hearing loss: A Bayesian kernel machine regression approach

Article

Full-text available

Dec 2022
ECOTOX ENVIRON SAFE

Background Exposure to heavy elements is considered one of the risks of hearing loss. The combined effect of multiple metals on different hearing losses has not been extensively studied. Methods This study deals with the association between different metals (Ba, Cd, Co, Cs, Mo, Pb, Mn, Sn, Sb, Tl, W) and hearing loss in the 2013–2018 National Health and Nutrition Examination Survey (NHANES). Associations were estimated by a generalized linear regression model (GLM) adjusting for age, gender, race/ethnicity, educational level, marital status, drinking status, hypertension, diabetes, smoking status, noise exposure, body mass index, and income-poverty ratio. The joint effects of mixed exposure were assessed by weighted quantile sum (WQS) model and Bayesian kernel machine regression (BKMR). The effect of multiple metals on speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) was further calculated. The odds ratio (OR) indicates the risk of every metal exposure. Results A total of 2205 adult participants were enrolled from NHANES. Cd, Pb, Sb and Sn had significant effects on total hearing loss. The WQS model found that mixed exposure to heavy elements was significantly positively associated with total hearing loss (OR: 1.136; 95% CI: 1.031, 1.253) after adjusting for various covariates. The ORs of mixed exposure in the SFHL and HFHL groups were 1.066 (95% CI: 0.994, 1.143) and 1.102 (95% CI: 1.013, 1.199), respectively. BKMR found a significant positive association between multiple metals and hearing loss. The results showed that there may be potential interactions between Cd, Pb and other metals. Conclusions Multiple metals have joint effects on hearing loss in the United States. The findings provide practitioners with important scientific evidence for possible interventions.

Diagnosis of health and safety at work in a Fire Station located in Chihuahua, Mexico: Diagnóstico de salud y seguridad en el trabajo en una Estación de Bomberos ubicada en Chihuahua, México

Article

Full-text available

May 2021

Resumen Esta investigación presenta un diagnóstico de seguridad y salud en el trabajo basado en el Modelo Obrero Italiano, para la identificación de riesgos y demandas fisiológicas en trabajadores de una estación de bomberos en Chihuahua, México. Se midieron los niveles de ruido, la pérdida auditiva y las partículas en suspensión. Se empleó el método ergonómico REBA para detectar el riesgo en el ascenso-descenso de la unidad móvil de rescate. Las demandas psicosociales se evaluaron a través del instrumento DAAS 21. El análisis estadístico se realizó utilizando el software SAS 9.0. El ruido excedió el Nivel Máximo Permitido (MLP) establecido por la norma mexicana. Se detectaron bomberos con hipoacusia leve a moderada. Se analizó el nivel de correlación entre umbral de audición (UA), antigüedad, edad e índice de masa corporal (IMC). Las partículas PM2.5 y PM10 fueron medidas y su concentración se encontró dentro del MLP. El método REBA categorizó el riesgo ergonómico como medio y muy alto. Los resultados del DASS 21 estuvieron en un rango normal para ansiedad-depresión-estrés. Los resultados brindan evidencia científica que demuestra la necesidad de equipos y atención médica para los bomberos. DOI: https://doi.org/10.54167/tecnociencia.v15i1.754

Hearing thresholds elevation and potential association with emotional problems among 1,914 children in Beijing, China

Article

Full-text available

Aug 2022

Objectives School-aged children may experience hearing loss and emotional problems. Previous studies have shown a bidirectional relationship between hearing loss and emotional problems in the elderly population, and we aimed to analyze the association between hearing thresholds and emotional problems in school-aged children. Methods Based on the Beijing Child Growth and Health Cohort (PROC) study, the hearing screenings were conducted in November 2019 using pure tone audiometry. A total of 1,877 parents completed the Strengths and Difficulties Questionnaire (SDQ) to assess children's emotional and behavioral status. We used generalized linear regression analysis to assess the potential association of emotional problems with hearing thresholds, based on multiple imputed datasets with a sample size of 1,914. Results The overall pass rate of hearing screening was 91.5%. The abnormal rate of SDQ total difficulties was 55.8%. Emotional symptoms were positively associated with left ear average hearing thresholds (β = 0.24, 95%CI: 0.08–0.40), and right ear average hearing thresholds (β = 0.18, 95%CI: 0.04–0.32). Conduct problems, hyperactivity/inattention, peer problems, and prosocial behaviors had no association with the pass rate of the hearing screening. Regarding emotional symptoms, boys with many fears and who are easily scared coincided with increased right ear average hearing thresholds (β = 0.67, 95%CI: 0.01–1.33). Girls having many worries, frequently feeling unhappy and downhearted were positively associated with left and right ear average hearing thresholds, respectively (β = 0.96, 95%CI: 0.20–1.73; β = 0.72, 95%CI: 0.07–1.37). Conclusions The co-occurrence of hearing problems and emotional problems of children aged 6–8 in Beijing attracts attention. It is important to address undiscovered hearing loss and emotional problems from the perspective of comorbidity driving factors.

Association of weight change across adulthood with hearing loss: A retrospective cohort study

Article

Full-text available

Jul 2022
INT J OBESITY

Objectives We aimed to investigate the relationship of weight change across adulthood with the risk of hearing loss. Methods The data from National Health and Nutrition Examination Surveys. Cox proportional hazards models were applied to explore the association between weight change and risk of hearing loss. Kaplan-Meier method was used to plot the survival curves associated with weight change patterns. Results Compared with participants who remained at normal weight, those with stable obese participants had increased risks of total hearing loss across adulthood, with hazard ratios of 1.24 (95% confidence intervals 1.11–1.38) from age 25 years to baseline, 1.09 (1.001–1.18) from 10 years before baseline to baseline, and 1.23 (1.10–1.37) from age 25 years to 10 years before baseline. Moving the obese to non-obese weight change pattern from middle to late adulthood was not significantly associated with an increased risk of total hearing loss (1.04, 0.91–1.19) and high-frequency hearing loss (1.02, 0.90–1.17), whereas changing from non-obese to obese body mass index over this period was associated with total hearing loss risk (1.20, 1.11–1.29), and speech- and high-frequency hearing loss (1.21, 1.07–1.36; 1.18, 1.09–1.28). Those moving from the non-obese to obese category between young and middle adulthood had a 16% (1.16, 1.02–1.33) higher risk of speech-frequency hearing loss. Conclusions Stable obesity and weight gain across adulthood are both associated with increased risks of hearing loss. Our findings imply that maintaining normal weight across adulthood is of great importance for preventing hearing loss in later life.

Association of Body Mass Index with Hearing Loss in Korean Adult Population

Article

Full-text available

May 2022

This study aimed to explore the relationship between body mass index (BMI) and hearing loss. We analyzed data from the Korean National Health Insurance Service Health Screening Cohort 2009–2019 (291,471 patients with hearing loss and 6,088,979 control participants). Both patient groups were subsequently divided into four groups according to BMI: <18.5 (underweight), 18.5–24.9 (normal), 25–29.9 (obese I), and ≥30 (obese II). To evaluate the relationship between BMI and hearing loss, multivariate logistic regression analysis was used, adjusting for age, sex, smoking, alcohol consumption, blood pressure, triglycerides, total cholesterol, low-density lipoprotein, proteinuria, serum creatinine, aspartate aminotransferase, alanine aminotransferase, and fasting glucose levels. The adjusted odds ratio (OR) of the underweight group for hearing loss was 1.21 (95% CI = 1.19–1.24) compared to the normal BMI group, whereas the adjusted ORs of obese I and obese II groups for hearing loss were 0.95 and 0.87, respectively. Being underweight was generally associated with an increased prevalence of hearing loss in the Korean adult population.

A High-Fat Diet Induces Low-Grade Cochlear Inflammation in CD-1 Mice

Article

Full-text available

May 2022
INT J MOL SCI

There is growing evidence for a relationship between gut dysbiosis and hearing loss. In-flammatory bowel disease, diet-induced obesity (DIO), and type 2 diabetes have all been linked to hearing loss. Here, we investigated the effect of a chronic high-fat diet (HFD) on the development of inner ear inflammation using a rodent model. Three-week-old CD-1 (Swiss) mice were fed an HFD or a control diet for ten weeks. After ten weeks, mouse cochleae were harvested, and markers of cochlear inflammation were assessed at the protein level using immunohistochemistry and at the gene expression level using quantitative real-time RT-PCR. We identified increased immunoexpres-sion of pro-inflammatory biomarkers in animals on an HFD, including intracellular adhesion molecule 1 (ICAM1), interleukin 6 receptor α (IL6Rα), and toll-like-receptor 2 (TLR2). In addition, increased numbers of ionized calcium-binding adapter molecule 1 (Iba1) positive macrophages were found in the cochlear lateral wall in mice on an HFD. In contrast, gene expression levels of inflam-matory markers were not affected by an HFD. The recruitment of macrophages to the cochlea and increased immunoexpression of inflammatory markers in mice fed an HFD provide direct evidence for the association between HFD and cochlear inflammation.

Searching for individual multi-sensory fingerprints and their links with adiposity – New insights from meta-analyses and empirical data

Article

Mar 2022
FOOD QUAL PREFER

Understanding how human senses are linked to eating behaviour and adiposity has been a key topic in sensory science, and a source of substantial controversy. Despite strong correlations in sensitivity across different sensory modalities, the fundamental question of whether individuals possess a ‘generalised sensitivity’ across senses remains unanswered. A better understanding of the relationships between multiple senses and eating behaviour is needed to tackle the current obesity epidemic. The present study synthesises published data regarding sensory sensitivities across modalities and presents new empirical findings. Specifically, we synthesise findings from 115 publications, including meta-analyses of 26 studies. These data reveal strong yet complex links between senses, highlighting the potential of multi-sensory analyses to better characterise sensory variations. In the empirical study, 98 Caucasian males (25.9 ± 5.8 years of age; body mass index: 26.8 ± 5.1 kg∙m⁻²) are tested for their supra-threshold sensory sensitivities (d’) to 11 food-related mono-modal stimuli across olfaction, gustation, vision, and audition. Canonical correlations on d’ for each modality reveal significant positive correlations between olfaction and gustation (p < 0.001), vision and audition (p < 0.001), as well as olfaction and audition (p = 0.008). Additionally, K-means cluster analysis identifies three broad groups of individuals with distinct multi-sensory fingerprints. Intriguingly, individuals in separate clusters are shown to have significantly different adiposity measures (body mass index: p = 0.01; body fat percentages: p = 0.05). Overall, this study sheds important new light on multi-sensory ‘fingerprints’, and their links to obesity.

Proteasome Subunit Beta Type-8 (PSMB8) Gene Polymorphisms in Vitiligo: A Possible Predictor of Auditory Involvement

Article

Dec 2021

Introduction: Proteasome subunit beta type-8 (PSMB8) is a protein that contributes to the complete assembly of 20S proteasome complexes, which play a role in the pathogenesis of vitiligo. Objective: The study aimed to evaluate the association between PSMB8 gene polymorphisms with vitiligo to assess its clinical significance among a sample of Egyptian patients with vitiligo. Methods: Genomic DNA was isolated from blood samples of 100 patients with vitiligo and 100 control subjects, and detection of PSMB8 polymorphisms was done by real-time PCR. Data analysis was carried out for the entire cohort. Statistics were performed using software. Audiological evaluation was performed, including pure-tone audiometry, extended high-frequency audiometry, transient evoked otoacoustic emissions, and auditory brainstem response. Results: There was a significant difference between PSMB8 genotypes and alleles distribution in patients and control groups. Ten percent of the study sample had sensorineural hearing loss. The patients with hearing loss were significantly older (P=0.0002), had significantly later age of onset (P=0.0007), longer duration (P=0.0021), higher body mass index (BMI) (P=0.045), and higher vitiligo area scoring index (VASI) scores (P=0.0015). All patients had extensive forms of vitiligo (generalized and universal). Regarding the VIT rs2071543 polymorphism, all of the patients with hearing loss were carrying the CA and AA genotypes. None of the patients carried the reference genotype, CC. The A allele of VIT rs2071543 was significantly associated with hearing affection (P=0.024). Conclusion: In our study, PSMB8 polymorphism was associated with the susceptibility to develop vitiligo and appeared to have clinical significance among the studied group of patients. Factors predicting auditory abnormalities should be further studied for early detection and management.

Leisure‐time physical activity and incidence of objectively assessed hearing loss: The Niigata Wellness Study

Article

Full-text available

Nov 2021
SCAND J MED SCI SPOR

Previous cohort study reported that high physical activity was associated with a low risk of self‐reported hearing loss in women. However, no studies have examined the association between physical activity and the development of hearing loss as measured using an objective assessment of hearing loss in men and women. Here we used cohort data to examine the association between leisure‐time physical activity and incidence of objectively assessed hearing loss in men and women. Participants included 27,537 Japanese adults aged 20–80 years without hearing loss, who completed a self‐administered physical activity questionnaire between April 2001 and March 2002. The participants were followed up for the development of hearing loss as measured by audiometry between April 2002 and March 2008. During follow‐up, 3691 participants developed hearing loss. Compared with the none physical activity group, multivariable adjusted hazard ratios for developing hearing loss were 0.93 (95% confidence interval, 0.86–1.01) and 0.87 (0.81–0.95) for the medium (<525 MET‐min/week) and high (≥525 MET‐min/week) physical activity groups, respectively (P for trend = .001). The magnitude of risk reduction was slightly greater in vigorous‐intensity activity than in moderate‐intensity activity (P for interaction = .01). Analysis by sound frequency showed that the amount of physical activity was inversely associated with high frequency hearing loss development (P for trend <.001), but not with low frequency hearing loss development (P for trend = .19). Higher level of leisure‐time physical activity was associated with lower incidence of hearing loss, particularly for vigorous‐intensity activities and high sound frequencies.

Dietary fat intake and risk of disabling hearing impairment: a prospective population-based cohort study

Article

Full-text available

Feb 2022
EUR J NUTR

Purpose To examine the associations of specific dietary fats with the risk of disabling hearing impairment in the UK Biobank study. Methods This cohort study investigated 105,592 participants (47,308 men and 58,284 women) aged ≥ 40 years. Participants completed a minimum of one valid 24-h recall (Oxford Web-Q). Dietary intake of total fatty acids, polyunsaturated fatty acids (PUFA), saturated fatty acids (SFA), and monounsaturated fatty acids (MUFA) was assessed at baseline. Functional auditory capacity was measured with a digit triplet test (DTT), and disabling hearing impairment was defined as a speech reception threshold in noise > − 3.5 dB in any physical exam performed during the follow-up. Results Over a median follow-up of 3.2 (SD: 2.1) years, 832 men and 872 women developed disabling hearing impairment. After adjustment for potential confounders, including lifestyles, exposure to high-intensity sounds, ototoxic medication and comorbidity, the hazard ratios (HRs), and 95% confidence interval (CI) of disabling hearing function, comparing extreme quintiles of intakes were 0.91 (0.71–1.17) for total fat, 1.09 (0.83–1.44) for PUFA, 0.85 (0.64–1.13) for SFA and 1.01 (0.74–1.36) for MUFA among men. Among women, HRs comparing extreme intakes were 0.98 (0.78–1.24) for total fat, 0.69 (0.53–0.91) for PUFA, 1.26 (0.96–1.65) for SFA, and 0.91 (0.68–1.23) for MUFA. Replacing 5% of energy intake from SFA with an equivalent energy from PUFA was associated with 25% risk reduction (HR: 0.75; 95% CI: 0.74–0.77) among women. Conclusions PUFA intake was associated with decreased risk of disabling hearing function in women, but not in men.

A call to action for the inclusion of ENT/Audiology services in the public health approach to addressing non-communicable diseases in the Pacific Islands

Article

Full-text available

Apr 2021

•Non-Communicable Diseases (NCDs): a public health crisis in the Pacific Islands.•Hearing loss is a silent disability associated with NCDs.•Hearing disability secondary to NCDs may be prevented/minimised.•Inclusion of ear/hearing health in NCD public heath agenda is advocated.•Ear/hearing health support should positively impact NCD outcomes.

Coffee consumption and risk of hearing impairment in men and women

Article

Full-text available

Nov 2020
CLIN NUTR

Background Hearing loss is the fifth leading cause of disability in the world. Coffee consumption might have a beneficial effect on hearing function because of the antioxidant and anti-inflammatory properties of some of its compounds. However, no previous longitudinal study has assessed the association between coffee consumption and the risk of hearing impairment. Objective To assess the prospective association between coffee consumption and risk of disabling hearing impairment in middle and older men and women from the UK Biobank study. Methods Analytical cohort with 36,923 participants (16,142 men and 20,781 women) [mean (SD): 56.6 (7.8) years, 1.6 (1.4) cups/d, and −7.6 (1.3) dB for age, total coffee consumption and speech reception threshold in noise at baseline, respectively]. At baseline, coffee consumption was measured with 3–5 multiple-pass 24-h food records. Hearing function was measured with a digit triplet test, and disabling hearing impairment was defined as a speech reception threshold in noise > -3.5 dB in any physical exam during the follow-up. Analyses were stratified by sex and Cox regression models were used to assess the prospective association proposed. Results Over 10 years of follow-up, 343 men and 345 women developed disabling hearing impairment. Among men, compared with those who consumed <1 cup/d of coffee, those who consumed 1, and ≥2 cups/d had a lower risk of hearing impairment (hazard ratio [95% confidence interval]: 0.72 [0.54–0.97] and 0.72 [0.56–0.92], respectively; P-trend: 0.01). This association was similar for caffeinated and decaffeinated coffee, and for filtered and non-filtered coffee, and was stronger in those with obesity (hazard ratio [95% confidence interval] for consumption of ≥2 vs. <1 cups/d: 0.39 [0.21–0.74]). No association was found between coffee and hearing function among women. Conclusions Coffee consumption was associated with lower risk of disabling hearing impairment in men but not in women. The association appeared to be independent of the coffee type and the preparation method.

Differential long noncoding RNA profiling of BMI in twins

Article

Sep 2020

Aim: Many efforts have been deployed to identify genetic variants associated with BMI. Alternatively, we explore epigenetic contribution to BMI variation by focusing on long noncoding RNAs (lncRNAs) which represents a key layer of epigenetic control. Materials & methods: We analyzed lncRNA expression in whole blood of 229 monozygotic twin pairs in association with BMI using generalized estimating equations. Results & conclusion: Six lncRNA probes were identified as significant (false discovery rate <0.05), with BMI showing causal effects on the expression of the significant lncRNAs. Functional annotation of differential profiles identified Gene ontology biological processes including kidney development, regulations of lipid biosynthetic process, circadian rhythm, notch signaling, etc. Whole blood lncRNAs are significantly expressed in response to BMI variation.

Research Progress on the Influence of Diet on Hearing Loss

Article

Jan 2024

儆王

Causal association between type 2 diabetes mellitus and acute suppurative otitis media: insights from a univariate and multivariate Mendelian randomization study

Article

Full-text available

May 2024

Background Type 2 diabetes mellitus (T2DM) and hearing loss (HL) constitute significant public health challenges worldwide. Recently, the association between T2DM and HL has aroused attention. However, possible residual confounding factors and other biases inherent to observational study designs make this association undetermined. In this study, we performed univariate and multivariable Mendelian Randomization (MR) analysis to elucidate the causal association between T2DM and common hearing disorders that lead to HL. Methods Our study employed univariate and multivariable MR analyses, with the Inverse Variance Weighted method as the primary approach to assessing the potential causal association between T2DM and hearing disorders. We selected 164 and 9 genetic variants representing T2DM from the NHGRI-EBI and DIAGRAM consortium, respectively. Summary-level data for 10 hearing disorders were obtained from over 500,000 participants in the FinnGen consortium and MRC-IEU. Sensitivity analysis revealed no significant heterogeneity of instrumental variables or pleiotropy was detected. Results In univariate MR analysis, genetically predicted T2DM from both sources was associated with an increased risk of acute suppurative otitis media (ASOM) (In NHGRI-EBI: OR = 1.07, 95% CI: 1.02-1.13, P = 0.012; In DIAGRAM: OR = 1.14, 95% CI: 1.02-1.26, P = 0.016). Multivariable MR analysis, adjusting for genetically predicted sleep duration, alcohol consumption, body mass index, and smoking, either individually or collectively, maintained these associations. Sensitivity analyses confirmed the robustness of the results. Conclusion T2DM was associated with an increased risk of ASOM. Strict glycemic control is essential for the minimization of the effects of T2DM on ASOM.

Genetically Predicted Sleep Traits and Sensorineural Hearing Loss: A Mendelian Randomization Study

Article

May 2024
LARYNGOSCOPE

Objective Observational studies suggest a potential association between sleep characteristics, sensorineural hearing loss (SNHL), and sudden SNHL (SSNHL), but causal evidence is scarce. We sought to clarify this issue using two‐sample Mendelian randomization analysis. Methods The inverse‐variance weighted (IVW) method was performed as primary analysis to assess bidirectional causal associations between sleep traits (chronotype, sleep duration, insomnia, daytime sleepiness, and snoring) and SNHL/SSNHL using publicly available Genome‐Wide Association Studies summary data from two large consortia (UK Biobank and FinnGen). Sensitivity analyses, including Mendelian randomization (MR)‐Egger, Mendelian randomization pleiotropy residual sum and outlier, weight median, Cochran's Q test, leave‐one‐out analysis, and potential pleiotropy analysis, were conducted to ensure robustness. Results IVW analysis found suggestive associations of morning chronotype (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.01–1.16, p = 0.031) and daytime sleepiness (OR = 1.88, 95% CI = 1.24–2.87, p = 0.003) with SNHL onset. Additionally, morning chronotype was nominally associated with SSNHL onset using IVW method (OR = 1.37, 95% CI = 1.10–1.71, p = 0.006). However, there was no evidence for the causal effect of SNHL and SSNHL on different sleep traits (all p > 0.05). Sensitivity analysis showed that the results were stable. Conclusion Within the MR limitations, morning chronotype and daytime sleepiness were underlying causal contributors to the burden of SNHL, indicating that optimal sleep might facilitate the prevention and development of SNHL. Level of Evidence 3 Laryngoscope , 2024

Causal relationship between psychiatric disorders and sensorineural hearing loss: A bidirectional two-sample mendelian randomization analysis

Article

Mar 2024
J PSYCHOSOM RES

Three Cases with High-Tone Sensorineural Hearing Loss Successfully Treated with a Kampo Formulation Daisaikoto高音域の感音難聴に大柴胡湯が奏効した3例

Article

Jan 2023

Neuro-otologic disease (e.g. hearing loss, tinnitus, dizziness) are often difficult to treat because their mechanisms and causes are not fully understood and Western medical approaches are limited. This time, we report 3 cases with high-tone sensorineural hearing loss successfully treated with a Kampo formulation daisaikoto. When high-tone sensorineural hearing loss remains after treatment of acute sensorineural deafness, or for high-tone acute sensorineural deafness, a Kampo medicine approach including abdominal patterns has the potential to improve hearing as well as comorbid symptoms such as tinnitus.

Microalbuminuria and Functional Iron Deficiency are Risk Factors for Hearing Loss in Adolescents

Article

Feb 2024
LARYNGOSCOPE

Objectives Renal impairment and some systemic diseases are associated with hearing loss (HL) in adults. However, studies of these relationship in adolescents are rare. The objective of this study was to determine the association between HL and renal or systemic disease in adolescents. Methods Subjects were extracted from the 5th Korea National Health and Nutrition Examination Survey from 2011 to 2012. We included adolescents aged 10–19 years old with normal tympanic membrane and those who underwent a physical and laboratory examination and pure tone audiometry. HL, high‐frequency hearing loss (HFHL), albuminuria, impaired glomerular filtration rate, hypertension, diabetes, and obesity were evaluated based on the data. Results Individuals with microalbuminruia (MIA) exhibited higher prevalence of HL ( p = 0.003) and HFHL ( p = 0.012) than those without MIA. The prevalence of HL and HFHL appeared to increase according to the severity of albuminuria. Additionally, individuals with HL or HFHL showed lower transferrin saturation (TSAT) than individuals without HL ( p = 0.002) or HFHL ( p = 0.001). And, HFHL was associated with lower ferritin levels ( p = 0.017). HL and HFHL were related to MIA ( p = 0.004 and p = 0.022, respectively) and TSAT ( p = 0.005 and p = 0.011, respectively) after controlling other factors. Conclusion MIA and TSAT level were independently associated with the HL and HFHL. Since MIA can be easily detected by dipstick test and urine analysis, hearing evaluations for individuals with MIA might be helpful to identify hearing impairments earlier in adolescents. Level of Evidence 3 (individual cross‐sectional study) Laryngoscope , 2024

Obesity and Disease

Chapter

Oct 2023

Alfred Poulos

Body weight and hearing screening in routine education program is needed for student who take online learning during the pandemic

Conference Paper

Jan 2023

Khuznita Dasa Novita

Adult body constitution and hearing loss: a bidirectional Mendelian randomisation study

Preprint

Full-text available

Feb 2023

Hearing-loss and -disorders represent possible mediating pathways in the associations between noise exposures and non-auditory health outcomes. In this context, we questioned whether the noise-obesity associations should consider hearing functions as possible mediators and applied Mendelian randomisation (MR) to investigate causal relationships between body constitution and hearing impairments. We obtained genetic associations from publicly available summary statistics from genome-wide association studies in European adult populations (N= from 210,088 to 360,564) for (i) body constitution: body mass index (BMI), waist circumference (WC) and body fat percentage (BFP), and (ii) hearing loss: sensorineural hearing loss, noise-induced hearing loss, and age-related hearing impairment (ARHI). We employed colocalisation analysis to investigate the genetic associations for BMI and ARHI liability within an FTO locus. We conducted bi-directional MR for the ‘forward’ (from body constitution to hearing) and ‘reverse’ directions. We applied the random-effects inverse variance-weighted method as the main MR method, with additional sensitivity analyses. Colocalisation analysis suggested that BMI and ARHI shared a causal variant at the FTOgene. We did not find robust evidence for causal associations from body constitution to hearing loss and suggested that some associations may be driven by FTO variants. In the reverse analyses, ARHI was negatively associated with BMI [effect size -0.22 (95% CI -0.44 to -0.01)] and BFP [effect size -0.23 (95% CI -0.45 to 0.00)], supporting the notion that ARHI may diminish body constitution. Finally, our data suggest that hearing may have little to no effect on explaining the association between noise exposure and body constitution.

Machine Learning Prediction of Objective Hearing Loss With Demographics, Clinical Factors, and Subjective Hearing Status

Article

Feb 2023
OTOLARYNG HEAD NECK

Objective: Hearing loss (HL) is highly prevalent, yet underrecognized and underdiagnosed. Lack of standardized screening, awareness, cost, and access to hearing testing present barriers to HL identification. To facilitate prescreening and selection of patients who warrant audiometric evaluation, we developed a machine learning (ML) model to predict speech-frequency pure-tone average (PTA). Study design: Cross-sectional study. Setting: National Health and Nutrition Examination Survey (NHANES). Methods: The cohort included 8918 adults (≥20 years) who completed audiometric testing with NHANES (2012-2018). The primary outcome measure was the prediction of better hearing ear speech-frequency PTA. Relevant predictors included demographics, medical conditions, and subjective assessment of hearing. Supervised ML with a tree-based architecture was used. Regression performance was determined by the mean absolute error (MAE) with binary classification assessed with area under the receiver operating characteristic curve (AUC). Results: Using the full set of predictors, the test set MAE between the ML-predicted and actual PTA was 5.29 dB HL (95% confidence interval [CI]: 4.97-5.61). The 5 most influential predictors of higher PTA were increased age, worse subjective hearing, male gender, increased body mass index, and history of smoking. The 5-factor abbreviated model performed comparably to the extended feature set with MAE 5.36 (95% CI: 5.03-5.69) and AUC for PTA > 25 dB HL of 0.92 (95% CI: 0.90-0.94). Conclusion: The ML model was able to predict PTA with patient demographics, clinical factors, and subjective hearing status. ML-based prediction may be used to identify individuals who could benefit most from audiometric evaluation.

The association of metabolic syndrome status with sensorineural hearing loss in pediatric obese patients

Article

Feb 2023
Int J Pediatr Otorhinolaryngol

Objectives: The prevalences of pediatric obesity and its associated comorbidities such as metabolic syndrome (metS) are rising. The aim of this study was to evaluate the association of metS status with sensorineural hearing loss in pediatric obese patients. Methods: A two-center observationalprospective study was designed. In this study, 252 consecutive treatment-naive pediatric obese patients aged 5.8-17.8 yr in a tertiary pediatric Endocrinology outpatient clinic were prospectively enrolled. Following standard clinical and biochemical evaluations, the obese patients were diagnosed as having metabolic syndrome (metS) or not according to Internetional Diabetes Federation Criteria. All the patients were evaluated with tympanometry and pure tone audiometry tests after otomicroscopic examination. Comparative analyses of audiometric evaluations were performed between metS+ and metS- subgroups of the obese patients. Results: The median age of the patients was 12.5 yr (range: 6.0-17.8 yr) and 56.3% of the patients were male. Metabolic syndrome was diagnosed in 82 (32.5%) patients. Age, gender distribution, history of the ventilation tube, and pubertal stage of the metS + patients and metS- counterparts were not statistically different (p > 0.05 for all). Pure tone hearing thresholds at all frequencies (125, 250, 500, 1k, 2k, 4k, 8k) were significantly higher in the metS + group then the metS- group (p˂0.05 for all). The tympanometry results were not statistically different between the two groups (p˃0.05). Abdominal obesity, hypertension, fasting hyperglycemia and dyslipidemia were not associated with increased hearing thresholds in metS + patients (p˃0.05 for all). Conclusion: Metabolic syndrome was associated with increased rates of subclinical hearing loss in our cohort. None of the investigated metS components emerged as a positive association with hearing loss in our cohort. Longitudinal follow-up of our cohort may help probe the causality of the association we found.

Association between overweight/obesity and risk of chronic rhinosinusitis: a prisma-compliant meta-analysis

Preprint

Full-text available

Sep 2022

Background Previously increasing studies revealed that overweight/obesity patients were significantly higher in groups of patients with common otorhinolaryngological inflammatory diseases. Although there still may have some controversies remaining in the effect of overweight/obesity on CRS. Therefore, this study aimed to perform a meta-analysis to explore whether overweight/obesity is a significant risk factor for CRS. Methods In this meta-analysis, we comprehensively and systematically searched for relevant published literatures concerning the correlation between overweight/obesity and risk of CRS through applying a predefined search terms as follows: (“overweight” OR “obesity”) AND (“chronic rhinosinusitis” OR “nasal polyps” OR “CRS” OR “CRSsNP” OR “CRSwNP”) in the following databases: PubMed, Web of science, Embase, Cochrane Library, and Google Scholar from inception to July 31, 2022. To explore the association between overweight/obesity and risk of developing CRS, multivariate odds ratio (OR) or relative risk (RR) and 95% confidence intervals (CI) were analyzed by using STATA software version16.0. This meta-analysis was registered with PROSPERO, CRD42022353658. Results Of 376 studies initially identified, only 7 studies concerning on the association between overweight/obesity and risk of CRS were eligible for the inclusion criteria eventually. The meta-analysis indicated that overweight was closely related to elevated risk of CRS (OR/RR = 1.04, 95%CI 0.90–1.18, P < 0.001). Meanwhile, the meta-analysis suggested that obesity was significantly related to elevated risk of CRS (OR/RR = 1.01, 95%CI 0.99–1.03, P < 0.001). Sensitivity analyses showed that there are no changes in the direction of effect when any one study was omitted from all meta-analyses. In addition, there was no significant risk of publication bias in this meta-analysis by performing Bgg’s test, Egger’s test, and funnel plot. Conclusion We found that overweight/obesity contributed to increasing the risk of developing CRS. Certainty, the result should be interpreted cautiously. Certainty, to obtain a more convincible result, more rigorous and high-quality clinical research will be warranted to be performed to evaluate the relationship between overweight/obesity and CRS in future.

The association of food intake on the development of hearing impairment after middle age among Japanese community dwellers

Article

Jul 2022
Auris Nasus Larynx

Objectives This study aimed to determine whether food intake modifies the risk of developing hearing impairment (HI) in Japanese adults in their 40s. Methods Data for individuals who were in their 40s with no HI at baseline and had participated in the survey multiple times were extracted from the National Institute for Longevity Sciences, Longitudinal Study of Aging. A total of 1846 samples observed for up to 11.5 years in 421 participants were included in the analyses. The average 3-day food intake was calculated. HI is defined as a pure-tone average of the better ear at frequencies of 0.5, 1, 2, and 4 kHz greater than 25 dB. The risk of developing HI in the 18 food groups was calculated longitudinally using multivariable cumulative data analyses. Results Even after adjusting basic confounding factors, food groups, and baseline hearing level, significant associations were found between beverage consumption and risk increments for HI (odds ratio [OR] = 2.374, 95% confidence interval [CI]:1.141–4.940) and also between mushroom intake and risk reduction (OR = 0.215, 95% CI:0.069–0.667). Other foods did not consistently show significant results when the combination of analysis variables were changed. Conclusions Although the effect of food on hearing is modest to the extent that the significance varies with the variables used in the analysis, the intake of beverages and mushrooms could potentially modify the risk of developing HI after middle age.

Diagnóstico de salud y seguridad en el trabajo en una Estación de Bomberos ubicada en Chihuahua, México: Diagnosis of health and safety at work in a Fire station located in Chihuahua, Mexico

Article

Full-text available

May 2021

Pathology of metabolism and hearing loss

Article

Sep 2021

This article summarizes some of the significant knowledge of interactions between metabolism pathology and hearing, in particular, diabetes mellitus, dyslipidemia, obesity and metabolic syndrome. Knowledge on interactions between metabolism pathology and auditory function is progressing and much of this progress comes from animal model and preclinical studies, as well as clinical research in humans. Since these pathologies are frequently found together, it is important to investigate them individually. The authors made an effort to deepen the topics separately, giving a vision that included epidemiology studies, physiopathological hypotheses, supported, when possible, by anatomopathological observations. In this review, we highlight potential methods and research directions, with the goal of advancing our understanding, prevention, diagnosis, and treatment of ear disturbance influenced by pathology of metabolism.

Sensorineural hearing loss and risk of stroke: a systematic review and meta-analysis

Article

Full-text available

May 2021

The aim of this systematic review and meta-analysis study was to clarify the effects of sensorineural hearing loss (SNHL) on the incidence of stroke. In line with this, PubMed, Scopus, Web of Science, and ScienceDirect databases were searched using related keywords and MeSH terms from inception to March 1, 2020. Out of the 1961 initial records, eight cohort studies comprising 4,564,202 participants were included, and their qualities were assessed using the Newcastle-Ottawa Scale (NOS). Then, the random-effects model was used to pool HR (95% CI) for risk of stroke; and heterogeneity was presented with I ² index. Subgroup analysis and publication bias tests were performed, and the pooled HR (95% CI) of stroke in SNHL was estimated as 1.31 (1.08, 1.53) for the unadjusted model and 1.33 (1.18, 1.49) for the adjusted model. Subgroup analysis indicates a significantly higher risk of stroke in patients with sudden SNHL (SSNHL) in comparison to age-related HL (ARHL) both in the unadjusted model, [HR = 1.46; 95% CI (1.08, 1.63)] versus [HR = 1.14; 95% CI (0.64, 1.65)], and in the adjusted model, [HR = 1.44; 95% CI (1.15, 1.74)] versus [HR = 1.29; 95% CI (1.24, 1.34)]. Our study showed that patients with SNHL face a higher risk of stroke than those without SNHL. It is necessary to perform hematologic and neurological examinations to help clinicians detect patients who are potentially at risk for stroke.

A Proposed Hypothesis on Dementia: Inflammation, Small Vessel Disease, and Hypoperfusion Is the Sequence That Links All Harmful Lifestyles to Cognitive Impairment

Article

Full-text available

Apr 2021

Antoine M. Hakim

There is growing consensus that certain lifestyles can contribute to cognitive impairment and dementia, but the physiological steps that link a harmful lifestyle to its negative impact are not always evident. It is also unclear whether all lifestyles that contribute to dementia do so through the same intermediary steps. This article will focus on three lifestyles known to be risk factors for dementia, namely obesity, sedentary behavior, and insufficient sleep, and offer a unifying hypothesis proposing that lifestyles that negatively impact cognition do so through the same sequence of events: inflammation, small vessel disease, decline in cerebral perfusion, and brain atrophy. The hypothesis will then be tested in a recently identified risk factor for dementia, namely hearing deficit. If further studies confirm this sequence of events leading to dementia, a significant change in our approach to this debilitating and costly condition may be necessary, possible, and beneficial.

Haemoglobin A1c and hearing impairment: longitudinal analysis using a large occupational health check-up data of Japan

Article

Full-text available

Sep 2018

Objectives The aim of this study was to determine whether haemoglobin A1c (HbA1c) level is associated with the incidence of hearing impairment accounting for smoking status and diabetic condition at baseline. Methods Participants were 131 689 men and 71 286 women aged 30–65 years and free of hearing impairment at baseline (2008) who attended Japanese occupational annual health check-ups from 2008 to 2015. We defined low-frequency hearing impairment at a hearing threshold >30 dB at 1 kHz and high frequency at >40 dB at 4 kHz in the better ear in pure-tone audiometric tests. HbA1c was categorised into seven categories. The association between HbA1c and hearing impairment was assessed using the Cox proportional hazards model. Results On 5 years mean follow-up, high HbA1c was associated with high-frequency hearing impairment. In non-smokers, HbA1c≥8.0% was associated with high-frequency hearing impairment, with a multivariable HR (95% CI) compared with HbA1c 5.0%–5.4% of 1.46 (1.10 to 1.94) in men and 2.15 (1.13 to 4.10) in women. There was no significant association between HbA1c and hearing impairment in smokers. A J-shaped association between HbA1c and high-frequency hearing impairment was observed for participants with diabetes at baseline. HbA1c was not associated with low-frequency hearing impairment among any participants. Conclusions HbA1c ≥8.0% of non-smokers and ≥7.3% of participants with diabetes was associated with high-frequency hearing impairment. These findings indicate that appropriate glycaemic control may prevent diabetic-related hearing impairment.

How body composition influences hearing status by mid-childhood and mid-life: The Longitudinal Study of Australian Children

Article

Full-text available

Oct 2018
INT J OBESITY

Background: Hearing loss is a disabling condition whose prevalence rises with age. Obesity-a risk factor common to many non-communicable diseases-now appears to be implicated. We aimed to determine: (1) cross-sectional associations of body composition measures with hearing in mid-childhood and mid-life and (2) its longitudinal associations with 10-year body mass index (BMI) trajectories. Methods: Design & Participants: There were 1481 11-12-year-old children and 1266 mothers in the population-based cross-sectional CheckPoint study nested within the Longitudinal Study of Australian Children (LSAC). Anthropometry (CheckPoint): BMI, fat/fat-free mass indices, waist-to-height ratio; LSAC wave 2-6-biennial measured BMI. Audiometry (CheckPoint): Mean hearing threshold across 1, 2 and 4 kHz; hearing loss (threshold > 15 dB HL, better ear). Analysis: Latent class models identifying BMI trajectories; linear/logistic regression quantifying associations of body composition/trajectories with hearing threshold/loss. Results: Measures of adiposity, but not fat-free mass, were cross-sectionally associated with hearing. Fat mass index predicted the hearing threshold and loss in children (β 0.6, 95% confidence interval (CI) 0.3-0.8, P < 0.001;, odds ratio (OR) 1.2, 95% CI 1.0-1.4, P = 0.05) and mothers (β 0.8, 95% CI 0.5-1.2, P < 0.001; OR 1.2, 95% CI 1.1-1.4, P = 0.003). Concurrent obesity (OR 1.5, 95% CI 1.1-2.1, P = 0.02) and waist-to-height ratio (WHtR) ≥ 0.6 (OR 1.6, 95% CI 1.2-2.3, P = 0.01) predicted maternal hearing, with similar but attenuated patterns in children. In longitudinal analyses, mothers', but not children's, BMI trajectories predicted hearing (OR for severely obese 3.0, 95% CI 1.4-6.6, P = 0.01). Conclusions: Concurrent adiposity and decade-long BMI trajectories showed small, but clear, associations with poor hearing in mid-life women, with emergent patterns by mid-childhood. This suggests that obesity may play a role in the rising global burden of hearing loss. Replication and mechanistic and body compositional studies could elucidate possible causal relationships.

Association between metabolic syndrome and sensorineural hearing loss: a cross-sectional study of 11,114 participants

Article

Full-text available

Nov 2017

Background/objectives Hearing loss (HL) is associated with certain diseases and affects health, resulting in a low quality of life. Some components of the metabolic syndrome (MetS) coincide with the risk factors for sensorineural hearing loss (SNHL). To date, very few studies have examined the link between MetS and HL. The aim of the current study was to try to understand the potential association between MetS and HL. Methods Using Iranian health surveys of professional drivers, we enrolled 11,114 individuals aged 20–60 years, whose main job is to operate a motor vehicle. We examined participants for the presence and absence of SNHL and the components of the MetS. Additionally, we investigated the relationship between MetS and the pure tone air conduction hearing thresholds of participants with SNHL, including low-frequency and high-frequency thresholds. Results This cross-sectional study consisted of 11,114 participants: 3202 (28.81%) diagnosed with MetS and 7911 (71.18%) without and 2772 (24.94%) with SNHL and 8432 (75.86%) without. Participants with SNHL had a higher number of components of MetS (P<0.001 for all components). Conclusion Our results demonstrated that an association possibly exists between different components of MetS (obesity, hypertension, hypertriglyceridemia, high fasting glucose levels, and waist circumference) and SNHL in a population of West Azerbaijan drivers. Therefore, it is important to schedule periodic checkups for drivers to detect and avoid the increase in MetS components at an early stage in this population.

Health Effects of Overweight and Obesity in 195 Countries over 25 Years

Article

Full-text available

Jul 2017

BACKGROUND Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain. METHODS We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015. RESULTS In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease. CONCLUSIONS The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.)

Risk of the Development of Diabetes and Cardiovascular Disease in Metabolically Healthy Obese People: The Korean Genome and Epidemiology Study

Article

Full-text available

Apr 2016
MEDICINE

The reported effects of a metabolically healthy obese (MHO) phenotype on diabetes and cardiovascular disease (CVD) risk are contradictory. Within the context of a population-based cohort study, we aimed to investigate the long-term risk of an MHO status for the development of diabetes and CVD, and whether consistency of this phenotype or age affected cardiometabolic outcomes. We recruited 7588 subjects without diabetes or CVD, aged 40 to 69 years at baseline examination, from the Korean Genome and Epidemiology Study, and followed-up these subjects for 10 years biennially. Participants were divided into 4 groups based on the body mass index and the presence of metabolic syndrome: metabolically healthy normal weight (MHNW), MHO, metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). We defined persistent phenotypes if subjects maintained the same phenotype at every visit from baseline to their last visit. Incident diabetes and CVD morbidity or mortality were identified during 10 years of follow-up. Compared to MHNW controls, MUNW and MUO groups had increased risk for development of diabetes (hazard ratio [HR] 3.0 [95% CI: 2.5–3.6], and 4.0 [3.4–4.7], respectively) and CVD (HR 1.6 [1.3–2.0], and 1.9 [1.5–2.4], respectively). However, the MHO group showed only a marginal increase in risk for diabetes and CVD (HR 1.2 [0.99–1.6], 1.4 [0.99–1.8], respectively). The impact of MHO on the development of diabetes was more prominent in younger individuals (HR 1.9 [1.2–3.1] vs 1.1 [0.8–1.4], <45 years vs ≥45 years at baseline). Only 15.8% of MHO subjects maintained the MHO phenotype at every visit from baseline to the 5th biennial examination (persistent MHO). In subjects with persistent MHO, the risk for diabetes and CVD was significantly higher than those with persistent MHNW (1.9 [1.2–3.1], 2.1 [1.2–3.7], respectively). MHO phenotype, even if maintained for a long time, was associated with a significantly higher risk for the development of diabetes and CVD in Korean subjects.

Trends in adult body-mass index in 200 countries from 1975 to 2014: A pooled analysis of 1698 population-based measurement studies with 19·2 million participants

Article

Full-text available

Apr 2016
LANCET

Summary Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. Funding Wellcome Trust, Grand Challenges Canada

Optimal waist circumference cut-off points and ability of different metabolic syndrome criteria for predicting diabetes in Japanese men and women: Japan Epidemiology Collaboration on Occupational Health Study

Article

Full-text available

Mar 2016
BMC PUBLIC HEALTH

Background We sought to establish the optimal waist circumference (WC) cut-off point for predicting diabetes mellitus (DM) and to compare the predictive ability of the metabolic syndrome (MetS) criteria of the Joint Interim Statement (JIS) and the Japanese Committee of the Criteria for MetS (JCCMS) for DM in Japanese. Methods Participants of the Japan Epidemiology Collaboration on Occupational Health Study, who were aged 20–69 years and free of DM at baseline (n = 54,980), were followed-up for a maximum of 6 years. Time-dependent receiver operating characteristic analysis was used to determine the optimal cut-off points of WC for predicting DM. Time-dependent sensitivity, specificity, and positive and negative predictive values for the prediction of DM were compared between the JIS and JCCMS MetS criteria. Results During 234,926 person-years of follow-up, 3180 individuals developed DM. Receiver operating characteristic analysis suggested that the most suitable cut-off point of WC for predicting incident DM was 85 cm for men and 80 cm for women. MetS was associated with 3–4 times increased hazard for developing DM in men and 7–9 times in women. Of the MetS criteria tested, the JIS criteria using our proposed WC cut-off points (85 cm for men and 80 cm for women) had the highest sensitivity (54.5 % for men and 43.5 % for women) for predicting DM. The sensitivity and specificity of the JCCMS MetS criteria were ~37.7 and 98.9 %, respectively. Conclusion Data from the present large cohort of workers suggest that WC cut-offs of 85 cm for men and 80 cm for women may be appropriate for predicting DM for Japanese. The JIS criteria can detect more people who later develop DM than does the JCCMS criteria. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2856-9) contains supplementary material, which is available to authorized users.

Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity

Article

Full-text available

Jan 2009

The association of obesity with hearing thresholds in women aged 18-40 years

Article

Full-text available

Apr 2016
ENDOCRINE

An elevation in hearing thresholds and decrease in hearing sensitivity in adults, particularly due to aging, are quite common. Recent studies have shown that, apart from aging, various other factors also play a role in auditory changes. Studies on the association of hearing loss (HL) with obesity are limited in advanced age cases and present contradictions. In this study, the association between obesity and hearing thresholds in women aged 18-40 years has been assessed. Forty women diagnosed with obesity (mean age, 31.8 years) and 40 healthy non-obese female controls (mean age, 30.5 years) were included in this prospective study. Each subject was tested with low (250, 500, 1000 and 2000 Hz) and high (4000, 6000 and 8000 Hz) frequency audiometry. In the case and control groups, the average hearing thresholds at low frequencies were 16.03 ± 4.72 and 16.15 ± 2.72 (p = 0.885) for the right ear, respectively, and 16.15 ± 5.92 and 14.71 ± 3.18 (p = 0.180) for the left ear, respectively. The average hearing threshold levels at high frequencies were 20.70 ± 10.23 and 15.33 ± 3.87 (p = 0.003), respectively, for the right ear, and 22.91 ± 15.54 and 15.87 ± 4.35 (p = 0.007), respectively, for the left ear with statistical significance. This is the first report on the association of obesity with hearing threshold in women aged 18-40 years. We have demonstrated that obesity may affect hearing function, particularly that related to high frequencies. Hearing loss can be prevented by avoidance or control of obesity and its risk factors. Moreover, an auditory screening of obese cases at an early stage may provide early diagnosis of HL and may also contribute to their awareness in the fight against obesity.

Associations of leisure-time, occupational, and commuting physical activity with risk of depressive symptoms among Japanese workers: A cohort study

Article

Full-text available

Sep 2015
INT J BEHAV NUTR PHY

Background: Leisure-time physical activity is associated with a lower risk of depression. However, the precise shape of the dose-response relationship remains elusive, and evidence is scarce regarding other domains of activity. We prospectively investigated associations of physical activity during leisure, work, and commuting with risk of depressive symptoms in Japanese workers. Methods: We conducted a cohort study of 29 082 Japanese workers aged 20-64 years without psychiatric disease (including depressive symptoms) at baseline with a maximum 5-year follow-up. Physical activity was self-reported. Depressive symptoms were assessed by 13 self-report questions on subjective symptoms. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for incidence of depressive symptoms were calculated using Cox regression analysis. Results: During a mean follow-up of 4.7 years, 6177 developed depressive symptoms. Leisure exercise showed a U-shaped association with risk of depressive symptoms adjusting for potential confounders. Additional adjustment for baseline depression scores attenuated the association, but it remained statistically significant (P for trend = 0.037). Compared with individuals who engaged in sedentary work, the HR (95 % CI) was 0.86 (0.81, 0.92) for individuals who stand or walk during work and 0.90 (0.82, 0.99) for those who are fairly active at work. However, the association disappeared after adjusting for baseline depression scores. Walking to and from work was not associated with depressive symptoms. Conclusions: The findings suggest that leisure-time exercise has a U-shaped relation with depressive symptoms in Japanese workers. Health-enhancing physical activity intervention may be needed for individuals who engage in sedentary work.

Components of Metabolic Syndrome as Risk Factors for Hearing Threshold Shifts

Article

Full-text available

Aug 2015
PLOS ONE

Hearing loss was a common, chronically disabling condition in the general population and had been associated with several inflammatory diseases. Metabolic syndrome, which was associated with insulin resistance and visceral obesity, was considered a chronic inflammatory disease. To date, few attempts had been made to establish a direct relationship between hearing loss and metabolic syndrome. The aim of the present study was to investigate the relationship between metabolic syndrome and hearing loss by analyzing the data in the reports of the National Health and Nutrition Examination Survey 1999-2004. This study included 2100 participants aged ≤ 65 years who enrolled in the National Health and Nutrition Examination Survey (1999-2004). We examined the relationship between the presence of different features of metabolic syndrome in the participants and their pure-tone air-conduction hearing thresholds, including low-frequency and high-frequency thresholds. After adjusting for potential confounders, such as age, medical conditions, and smoking status, the participants with more components of metabolic syndrome were found to have higher hearing thresholds than those with fewer components of metabolic syndrome (p < 0.05 for a trend). The low-frequency hearing threshold was associated with individual components of metabolic syndrome, such as abdominal obesity, high blood pressure, elevated triglycerides, and a low level of high-density lipoprotein cholesterol (HDL-C) (p < 0.05 for all parameters). The results indicated that the presence of a greater number of components of metabolic syndrome was significantly associated with the hearing threshold in the US adult population. Among the components of metabolic syndrome, the most apparent association was observed between low HDL and hearing loss.

The Association between Metabolic Syndrome or Chronic Kidney Disease and Hearing Thresholds in Koreans: The Korean National Health and Nutrition Examination Survey 2009-2012

Article

Full-text available

Mar 2015
PLOS ONE

Background: The aim of this study was to determine whether metabolic syndrome (MetS) or chronic kidney disease (CKD) is associated with hearing thresholds in the general Korean population. Patients and methods: A total of 16,554 participants were included in this study. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III guidelines, and CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 or a dipstick proteinuria result of ≥1+. The hearing thresholds were measured at 0.5, 1, 2, 3, 4, and 6 kHz. Low-frequency (Freq) was defined as pure-tone averages at 0.5 and 1 kHz, while Mid-Freq and High-Freq were defined as the average thresholds at mid-frequency (2 and 3 kHz) and high frequency (4 and 6 kHz), respectively. Results: In men, the hearing thresholds were 15.1 ± 14.5 dB, 22.2 ± 21.3 dB, and 37.3 ± 26.5 dB for Low-, Mid-, and High-Freq, respectively. In women, the hearing thresholds were 14.9 ± 15.3 dB, 16.6 ± 18.0 dB, and 26.1 ± 21.5 dB for Low-, Mid-, and High-Freq, respectively. The hearing thresholds for men were significantly higher than the hearing thresholds for women in all 3 threshold categories. Male and female subjects with MetS or CKD had higher hearing thresholds than the subjects that did not have these disorders. In the multivariate analysis, MetS was associated with increased hearing thresholds in women, and CKD was associated with increased hearing thresholds in men and women. Conclusion: MetS is associated with hearing thresholds in women, and CKD is associated with hearing thresholds in men and women. Therefore, patients with MetS or CKD should be closely monitored for hearing impairment.

Metabolically Healthy Obesity, Presence or Absence of Fatty Liver, and Risk of Type 2 Diabetes in Japanese Individuals: Toranomon Hospital Health Management Center Study 20 (TOPICS 20)

Article

Full-text available

May 2014
J CLIN ENDOCR METAB

Objective: We investigated whether the metabolically healthy obese (MHO) phenotype was associated with an increased risk of the development of diabetes. If so, we aimed to determine what factors could explain this finding. Design, setting, and participants: Studied were 8090 Japanese individuals without diabetes. Metabolic health status was assessed by common clinical markers: blood pressure, triglycerides, high-density lipoprotein-cholesterol, and fasting glucose concentrations. The cutoff value for obesity or normal weight (NW) was a body mass index of 25.0 kg/m(2). Results: The 5-year incidence rate of diabetes was 1.2% (n = 58 of 4749) in metabolically healthy NW (MHNW) individuals, 2.8% (n = 20 of 719) in MHO individuals, 6.0% (n = 102 of 1709) in metabolically abnormal NW individuals, and 10.3% (n = 94 of 913) in metabolically abnormal obese individuals. Although MHO individuals had no or one metabolic factor, 47.8% had ultrasonographic fatty liver (FL). The MHO group had a significantly increased risk of diabetes compared with the MHNW group [multivariate adjusted odds ratio (OR) 2.23 (95% confidence interval [CI] 1.33, 3.75)], but this risk was attenuated after adjustment for FL. Compared with the MHNW/non-FL group, the risk of diabetes in the MHO/non-FL group was not significantly elevated [OR 1.01 (95% CI 0.35, 2.88)]. However, the MHO/FL and MHNW/FL groups had similarly elevated risks of diabetes [OR 4.09 (95% CI 2.20, 7.60) and 3.16 (1.78, 5.62), respectively]. Conclusions: Almost half of the MHO participants had FL, which partially explained the increased risk of diabetes among the obese phenotypes. The presence of FL should be evaluated to assess whether an individual was actually in a metabolically benign state for the prediction of diabetes.

Diet-Induced Obesity Exacerbates Auditory Degeneration via Hypoxia, Inflammation, and Apoptosis Signaling Pathways in CD/1 Mice

Article

Full-text available

Apr 2013
PLOS ONE

The aim of this study was to investigate the mechanisms of diet-induced obesity on hearing degeneration in CD/1 mice. Sixty 4-week-old male CD/1 mice were randomly and equally divided into 2 groups. For 16 weeks, the diet-induced obesity (DIO) group was fed a high fat diet and the control group was fed a standard diet of 13.43 % kcal fat. The morphometry, biochemistry, auditory brainstem response thresholds, omental fat, and histopathology of the cochlea were compared between the beginning and end of the study (4 vs. 20 weeks old). The results show that the body weight, fasting plasma triglyceride concentrations, and omental fat weight were higher in the DIO group than in the control group at the end of experiment. The auditory brainstem response thresholds at high frequencies were significantly elevated in the DIO group compared to those of the control group. Histology studies showed that, compared to the control group, the DIO group had blood vessels with smaller diameters and thicker walls in the stria vascularis at the middle and basal turns of the cochlea. The cell densities in the spiral ganglion and spiral ligament at the basal turn of the cochlea were significantly lower in the DIO group. Immunohistochemical staining showed that hypoxia-induced factor 1 (HIF-1), tumor necrosis factor alpha (TNF-α), nuclear factor kappa B (NF-κB), caspase 3, poly(ADP-ribose) polymerase-1, and apoptosis inducing factor were all significantly more dense in the spiral ganglion and spiral ligament at the basal turn of cochlea in the DIO group. Our results suggest that diet-induced obesity exacerbates hearing degeneration via increased hypoxia, inflammatory responses, and cell loss in the spiral ganglion and spiral ligament and is associated with the activation of both caspase-dependent and -independent apoptosis signaling pathways in CD/1 mice.

Oxidative Stress in the Cochlea: An Update

Article

Full-text available

Oct 2010
CURR MED CHEM

This paper will focus on understanding the role and action of reactive oxygen species (ROS) and reactive nitrogen species (RNS) in the molecular and biochemical pathways responsible for the regulation of the survival of hair cells and spiral ganglion neurons in the auditory portion of the inner ear. The pivotal role of ROS/RNS in ototoxicity makes them potentially valuable candidates for effective otoprotective strategies. In this review, we describe the major characteristics of ROS/RNS and the different oxidative processes observed during ototoxic cascades. At each step, we discuss their potential as therapeutic targets because an increasing number of compounds that modulate ROS/RNS processing or targets are being identified.

The Obese Without Cardiometabolic Risk Factor Clustering and the Normal Weight With Cardiometabolic Risk Factor Clustering: Prevalence and Correlates of 2 Phenotypes Among the US Population (NHANES 1999-2004)

Article

Full-text available

Aug 2008

The prevalence and correlates of obese individuals who are resistant to the development of the adiposity-associated cardiometabolic abnormalities and normal-weight individuals who display cardiometabolic risk factor clustering are not well known. The prevalence and correlates of combined body mass index (normal weight, < 25.0; overweight, 25.0-29.9; and obese, > or = 30.0 [calculated as weight in kilograms divided by height in meters squared]) and cardiometabolic groups (metabolically healthy, 0 or 1 cardiometabolic abnormalities; and metabolically abnormal, > or = 2 cardiometabolic abnormalities) were assessed in a cross-sectional sample of 5440 participants of the National Health and Nutrition Examination Surveys 1999-2004. Cardiometabolic abnormalities included elevated blood pressure; elevated levels of triglycerides, fasting plasma glucose, and C-reactive protein; elevated homeostasis model assessment of insulin resistance value; and low high-density lipoprotein cholesterol level. Among US adults 20 years and older, 23.5% (approximately 16.3 million adults) of normal-weight adults were metabolically abnormal, whereas 51.3% (approximately 35.9 million adults) of overweight adults and 31.7% (approximately 19.5 million adults) of obese adults were metabolically healthy. The independent correlates of clustering of cardiometabolic abnormalities among normal-weight individuals were older age, lower physical activity levels, and larger waist circumference. The independent correlates of 0 or 1 cardiometabolic abnormalities among overweight and obese individuals were younger age, non-Hispanic black race/ethnicity, higher physical activity levels, and smaller waist circumference. Among US adults, there is a high prevalence of clustering of cardiometabolic abnormalities among normal-weight individuals and a high prevalence of overweight and obese individuals who are metabolically healthy. Further study into the physiologic mechanisms underlying these different phenotypes and their impact on health is needed.

Occupational Noise, Smoking, and a High Body Mass Index are Risk Factors for Age-related Hearing Impairment and Moderate Alcohol Consumption is Protective: A European Population-based Multicenter Study

Article

Full-text available

Jun 2008

A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data (pure-tone average [PTA]) were collected and the participants filled out a questionnaire on environmental risk factors and medical history. People with a history of disease that could affect hearing were excluded. PTAs were adjusted for age and sex and tested for association with exposure to risk factors. Noise exposure was associated with a significant loss of hearing at high sound frequencies (>1 kHz). Smoking significantly increased high-frequency hearing loss, and the effect was dose-dependent. The effect of smoking remained significant when accounting for cardiovascular disease events. Taller people had better hearing on average with a more pronounced effect at low sound frequencies (<2 kHz). A high body mass index (BMI) correlated with hearing loss across the frequency range tested. Moderate alcohol consumption was inversely correlated with hearing loss. Significant associations were found in the high as well as in the low frequencies. The results suggest that a healthy lifestyle can protect against age-related hearing impairment. Electronic supplementary material The online version of this article (doi: 10.1007/s10162-008-0123-1) contains supplementary material, which is available to authorized users.

Adolescent Obesity Is an Independent Risk Factor for Sensorineural Hearing Loss: Results From the National Health and Nutrition Examination Survey 2005 to 2010

Article

Aug 2018

Objective: We investigated the hypothesis that childhood obesity is a risk factor for sensorineural hearing loss (SNHL) independent of other metabolic risk factors. Study design: A complex, multistage, stratified geographic area design for collecting representative data from noninstitutionalized US population. Methods: A total of 5,638 adolescents between age 12 and 19 from the NHANES database (2005-2010) were studied. Subjects with body mass index >= 95th percentile were classified as obese. SNHL was defined as average pure-tone greater than 15 dB HL for 0.5, 1, and 2 kHz or 3, 4, 6, and 8 kHz in at least 1 ear. Multivariable logistic regression models assessed incident hearing loss odds across obese patients in comparison with normal weight individuals (5th-85th percentile). Multivariable models included age, sex, socioeconomic status, race, smoke exposure, high density lipoprotein level, triglyceride level, elevated blood pressure measurement, hemoglobin A1C level, and C-reactive protein level. Results: The rate of SNHL was 21.5% in obese and 13.44% in normal weight adolescents (p < 0.0001). In multivariable analyses, obesity was associated with 1.73-fold increase in the odds of SNHL (95% CI: 1.25-2.40, p value = 0.006). Potentially confounding and mediating factors had minimal effect on the odds of SNHL in obese study participants (OR range of 1.69-1.75, all p values <= 0.01). Conclusions: Obesity is associated with higher prevalence of SNHL in adolescents independent of other potential risk factors. Future longitudinal investigations and mechanistic studies are warranted.

Metabolic syndrome is associated with hearing loss among a middle-aged and older Chinese population: a cross-sectional study

Article

Apr 2018

Background: Although the association of metabolic syndrome (MetS) and hearing loss has been evaluated, findings are controversial. This study investigated this association in a Chinese population. Methods: A cross-sectional study including a total of 18,824 middle-aged and older participants from the Dongfeng-Tongji Cohort study was conducted. Hearing loss was defined as the pure-tone average (PTA) of frequencies 0.5, 1.0, 2.0, and 4.0 kHz >25 decibels hearing level (dB HL) in the better ear and graded as mild (PTA 26-40 dB HL), moderate (PTA >40 to ≤60 dB HL), and severe (PTA >60 dB HL). MetS was defined according to the International Diabetes Foundation (IDF) criteria of 2005. Association analysis was performed by logistic regression. Results: After adjustment for potential confounders, participants with MetS showed higher OR of hearing loss (OR, 1.11; 95% CI: 1.03-1.19). The MetS components including central obesity (OR, 1.07; 95% CI: 1.01-1.15) and hyperglycemia (OR, 1.12; 95% CI: 1.04-1.20) were also positively associated with hearing loss. Low HDL-C levels were also associated with higher OR of moderate/severe hearing loss (OR, 1.21; 95% CI: 1.07-1.36). Conclusions: The MetS, including its components central obesity, hyperglycemia, and low HDL-C levels were positively associated with hearing loss.

Smoking, Smoking Cessation, and the Risk of Hearing Loss: Japan Epidemiology Collaboration on Occupational Health Study

Article

Mar 2018
NICOTINE TOB RES

Introduction: We aimed to determine the prospective association of smoking status, smoking intensity, and smoking cessation with the risk of hearing loss in a large Japanese cohort. Methods: The cohort study included 50195 employees, who were aged 20-64 years and free of hearing loss at baseline. Participants were followed up for a maximum of 8 years. Pure-tone audiometric testing was performed annually to identify hearing loss at 1 and 4 kHz. Cox proportional hazards regression models were used to investigate the association between smoking and hearing loss. Results: During follow-up, 3532 individuals developed high-frequency hearing loss, and 1575 developed low-frequency hearing loss. The hazard ratio (HR) associated with current smokers was 1.6 (95% confidence interval [CI] = 1.5 to 1.7) and 1.2 (95% CI = 1.1 to 1.4) for high- and low-frequency hearing loss, respectively, as compared with never smokers. The risk of high- and low-frequency hearing loss increased with the number of cigarettes smoked per day (both p for trend <.001). The HR associated with former smokers was 1.2 (95% CI = 1.1 to 1.3) and 0.9 (95% CI = 0.8 to 1.1) for high- and low-frequency hearing loss, respectively. The analysis by quitting years showed a decline in risk of hearing loss after quitting smoking, even among those who quitted less than 5 years before baseline. Conclusions: Smoking is associated with increased risk of hearing loss, especially at the high frequency, in a dose-response manner. The excess risk of hearing loss associated with smoking disappears in a relatively short period after quitting. Implications: The prospective association between smoking and hearing loss has not been well studied. To the best of our knowledge, our study is the largest to date investigating the association between smoking and incident hearing loss. Our results indicate that smoking is associated with increased risk of hearing loss in a dose-response manner. Quitting smoking virtually eliminates the excess risk of hearing loss, even among quitters with short duration of cessation. These results suggest that smoking may be a causal factor for hearing loss, although further research would be required to confirm this. If so, this would emphasize the need for tobacco control to prevent or delay the development of hearing loss.

The Association Between Age-Related Hearing Impairment and Metabolic Syndrome in Korean Women: 5-Year Follow-Up Observational Study

Article

Mar 2017

Background: Although several observational studies showed a relationship between various conditions of metabolic syndrome (MetS) and hearing threshold, there are no studies about longitudinal audiometric results related MetS. The aim of this study was to investigate the association between MetS and age-related hearing impairment (ARHI) through a large, average 5-year longitudinal follow-up, clinical comparative analysis. Materials and methods: We recruited 1381 women older than 50 years who were enrolled in 2007 and reevaluated in 2012. They had normal or symmetrical sensorineural hearing loss. For the evaluation of the independent impact of MetS on hearing, multivariate analysis was used. Results: The average follow-up period was 5.0 ± 0.2 years. Subjects with MetS had higher hearing thresholds than subjects without MetS. The loss in high-frequency hearing (≥2000 Hz) progressed more rapidly in women with MetS over a 5-year period. Conclusion: Our analysis using longitudinal and large data revealed that MetS is associated with ARHI in women 50 years and older. High-frequency hearing loss tended to be greater in women with MetS than in those without MetS at the 5-year follow-up. Therefore, older women with MetS should be followed up closely for hearing evaluation.

A narrative review of obesity and hearing loss

Article

Feb 2017

The comorbidities related to obesity are both extensive and established, but as the prevalence of obesity increases globally, so to do the number of its associated conditions. The relationship between hearing impairment and obesity is a relatively recent research interest, but significant as both conditions have the ability to substantially reduce an individual’s quality of life both physically and psychologically. Obesity has a significant effect on vascular function and this may impact highly vascular organs such as the auditory system. This review aims to provide an overview of the existing literature surrounding the association between hearing loss and obesity, in order to emphasise these two highly prevalent conditions, and to identify areas of further investigation. Our literature search identified a total of 298 articles with eleven articles of relevance to the review. The existing literature in this area is sparse with interest ranging from obesity and its links to age-related hearing impairment (ARHI) and sudden sensorineural hearing loss (SSNHL), to animal models and genetic syndromes that incorporate both disorders. A key hypothesis for the underlying mechanism for the relationship between obesity and hearing loss is that of vasoconstriction in the inner ear, whereby strain on the capillary walls due to excess adipose tissue causes damage to the delicate inner ear system. The identified articles in this review have not established a causal relationship between obesity and hearing impairment. Further research is required to examine the emerging association between obesity and hearing impairment, and identify its potential underlying mechanisms.

Duration and degree of weight change and risk of incident diabetes: Japan Epidemiology Collaboration on Occupational Health Study

Article

Dec 2016
PREV MED

We prospectively examined diabetes risk in association with a summary measure of degree and duration of weight change. The study participants were 51,777 employees from multiple companies in Japan, who were aged 30-59years, free of diabetes at baseline, and followed up for 7years (2008-2015). Exposure was cumulative body mass index (BMI)-years, which was defined as the area of BMI units above or below baseline BMI during follow-up, and was treated as a time-dependent variable in the Cox proportional hazards regression models. During the 263,539 person-years of follow-up, 3465 participants developed diabetes. The adjusted hazard ratio (HR) of diabetes for a 1-unit increase in cumulative BMI-years was 1.11 (95% confidence interval (CI): 1.09, 1.12). The association was more pronounced among overweight (HR=1.11; 95% CI: 1.08, 1.14) and obese (HR=1.12; 95% CI: 1.08, 1.15) adults compared with normal- and under-weight (HR=1.07; 95% CI: 1.03, 1.11) adults (P for interaction of cumulative BMI-years X baseline BMI-group=0.002). The association of higher cumulative BMI-years with incident diabetes did not substantially differ by metabolic phenotype. The present results emphasize the importance of avoiding additional weight gain over an extended period of time for the prevention of type 2 diabetes, especially among overweight and obese adults, irrespective of metabolic health status.

Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies

Article

Jan 2004
LANCET

Who Consultation

Lipotoxicity: when tissues overeat

Article

Jun 2003

Jean Schaffer

Purpose of review: This review will provide the reader with an update on our understanding of the adverse effects of fatty acid accumulation in non-adipose tissues, a phenomenon known as lipotoxicity. Recent studies will be reviewed. Cellular mechanisms involved in the lipotoxic response will be discussed. Physiologic responses to lipid overload and therapeutic approaches to decreasing lipid accumulation will be discussed, as they add to our understanding of important pathophysiologic mechanisms. Recent findings: Excess lipid accumulation in non-adipose tissues may arise in the setting of high plasma free fatty acids or triglycerides. Alternatively, lipid overload results from mismatch between free fatty acid import and utilization. Evidence from human studies and animal models suggests that lipid accumulation in the heart, skeletal muscle, pancreas, liver, and kidney play an important role in the pathogenesis of heart failure, obesity and diabetes. Excess free fatty acids may impair normal cell signaling, causing cellular dysfunction. In some circumstances, excess free fatty acids induce apoptotic cell death. Summary: Recent studies provide clues regarding the cellular mechanisms that determine whether excess lipid accumulation is well tolerated or cytotoxic. Critical in this process are physiologic mechanisms for directing excess free fatty acids to specific tissues as well as cellular mechanisms for channeling excess fatty acid to particular metabolic fates. Insight into these mechanisms may contribute to the development of more effective therapies for common human disorders in which lipotoxicity contributes to pathogenesis.

Preventing and managing the global epidemic. Report of a WHO consultation [M]

Article

Jan 2000

W.H.O. Obesity

Smoking, Central Adiposity, and Poor Glycemic Control Increase Risk of Hearing Impairment

Article

May 2015
J AM GERIATR SOC

To determine associations between smoking, adiposity, diabetes mellitus, and other risk factors for cardiovascular disease (CVD) and the 15-year incidence of hearing impairment (HI). A longitudinal population-based cohort study (1993-95 to 2009-10), the Epidemiology of Hearing Loss Study (EHLS). Beaver Dam, Wisconsin. Participants in the Beaver Dam Eye Study (1988-90; residents of Beaver Dam, WI, aged 43-84 in 1987-88) were eligible for the EHLS. There were 1,925 participants with normal hearing at baseline. Fifteen-year cumulative incidence of HI (pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz greater than 25 decibels hearing level in either ear). Cigarette smoking, exercise, and other factors were ascertained according to questionnaire. Blood pressure, waist circumference, body mass index, and glycosylated hemoglobin were measured. Follow-up examinations (≥1) were obtained from 87.2% (n = 1,678; mean baseline age 61). The 15-year cumulative incidence of HI was 56.8%. Adjusting for age and sex, current smoking (hazard ratio (HR) = 1.31, P = .048), education (<16 years; HR = 1.35, P = .01), waist circumference (HR = 1.08 per 10 cm, P = .02), and poorly controlled diabetes mellitus (HR = 2.03, P = .048) were associated with greater risk of HI. Former smokers and people with better-controlled diabetes mellitus were not at greater risk. Smoking, central adiposity, and poorly controlled diabetes mellitus predicted incident HI. These well-known risk factors for CVD suggest that vascular changes may contribute to HI in aging. Interventions targeting reductions in smoking and adiposity and better glycemic control in people with diabetes mellitus may help prevent or delay the onset of HI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Body Mass Index, Waist Circumference, Physical Activity, and Risk of Hearing Loss in Women

Article

Oct 2013

Acquired hearing loss is highly prevalent, but prospective data on potentially modifiable risk factors are limited. In cross-sectional studies, higher body mass index (BMI), larger waist circumference, and lower physical activity have been associated with poorer hearing, but these have not been examined prospectively. We examined the independent associations between BMI, waist circumference, and physical activity, and self-reported hearing loss in 68,421 women in the Nurses' Health Study II from 1989 to 2009. Baseline and updated information on BMI, waist circumference, and physical activity was obtained from biennial questionnaires. After more than 1.1 million person-years of follow-up, 11,286 cases of hearing loss were reported to have occurred. Higher BMI and larger waist circumference were associated with increased risk of hearing loss. Compared with women with BMI <25 kg/m(2), the multivariate-adjusted relative risk (RR) for women with BMI ≥40 was 1.25 (95% confidence interval [CI], 1.14-1.37). Compared with women with waist circumference <71 cm, the multivariate-adjusted RR for waist circumference >88 cm was 1.27 (95% CI, 1.17-1.38). Higher physical activity was related inversely to risk; compared with women in the lowest quintile of physical activity, the multivariate-adjusted RR for women in the highest quintile was 0.83 (95% CI, 0.78-0.88). Walking 2 hours per week or more was associated inversely with risk. Simultaneous adjustment for BMI, waist circumference, and physical activity slightly attenuated the associations but they remained statistically significant. Higher BMI and larger waist circumference are associated with increased risk, and higher physical activity is associated with reduced risk of hearing loss in women. These findings provide evidence that maintaining healthy weight and staying physically active, potentially modifiable lifestyle factors, may help reduce the risk of hearing loss.

Obesity is Associated With Sensorineural Hearing Loss in Adolescents

Article

Dec 2013
LARYNGOSCOPE

Objectives/HypothesisChildhood obesity, defined as body mass index (BMI)95%, is a significant health problem associated with a variety of disorders, and in adults it has been found to be a risk factor for hearing loss. We investigated the hypothesis that obese children are at increased risk of sensorineural hearing loss (SNHL). Study DesignA complex, multistage, stratified geographic area design for collecting representative data from noninstitutionalized U.S. population. Methods Relevant cross-sectional data from the National Health and Nutrition Examination Survey, 2005 to 2006, for 1,488 participants 12 to 19 years of age was examined. Subjects were classified as obese if their BMI95th percentile. SNHL was defined as average pure-tone level greater than 15 dB for 0.5, 1, and 2 kHz (low frequency) and 3, 4, 6, and 8 kHz (high frequency). ResultsCompared to normal weight participants (BMI 5%-85%), obesity in adolescents was associated with elevated pure tone hearing thresholds and greater prevalence of unilateral low-frequency SNHL (15.2 vs. 8.3%, P=0.01). In multivariate analyses, obesity was associated with a 1.85 fold increase in the odds of unilateral low-frequency SNHL (95% CI: 1.10-3.13) after controlling for multiple hearing-related covariates. Conclusions We demonstrate for the first time that obesity in childhood is associated with higher hearing thresholds across all frequencies and an almost 2-fold increase in the odds of unilateral low-frequency hearing loss. These results add to the growing literature on obesity-related health disturbances and also add to the urgency in instituting public health measures to reduce it. Level of Evidence2b. Laryngoscope, 123:3178-3184, 2013

Obesity and risk of hearing loss: A prospective cohort study

Abstract

No full-text available