Abstract
This study investigated the synergistic effects of risk factors on age-related hearing loss (ARHL) using nationwide cross-sectional data of 33,552 individuals from the 2010‒2013 Korea National Health and Nutrition Examination Survey. Patients with ARHL were selected based on their pure-tone audiometry results. Previously reported risk factors for ARHL were analyzed using logistic regression and propensity score-matching, and synergistic effects between risk factors were analyzed using propensity score-matching. Of the 12,570 individuals aged 40–79 years, 2002 (15.9%) met the criteria for ARHL. Male sex, exposure to occupational noise, and diabetes showed a significant relationship with ARHL (p < 0.05) in both the logistic regression and propensity score-matching analyses. Smoking and diabetes showed the strongest significant synergistic effect on ARHL (odds ratio [OR] 1.963, 95% confidence interval [CI] 1.285‒2.998; p = 0.002). In the subgroup analysis based on smoking status, current smokers with diabetes had a significant relationship with ARHL (OR 1.883, CI 1.191‒2.975; p = 0.009), whereas ex-smokers with diabetes did not (OR 1.250; CI 0.880‒1.775; p = 0.246). This implies that current smokers with diabetes may benefit from the cessation of smoking. In conclusion, patients with diabetes should strictly avoid or cease smoking to prevent the progression of ARHL.
Highlights
This study investigated the synergistic effects of risk factors on age-related hearing loss (ARHL) using nationwide cross-sectional data of 33,552 individuals from the 2010‒2013 Korea National Health and Nutrition Examination Survey
A definite causative gene contributing to the development of ARHL in the population is unknown, numerous genes with common polymorphisms or rare variants have been suggested as a cause for ARHL in some patients; for instance, KCNQ4 is a candidate gene associated with hearing loss that progresses with age[16,21,22,23,24,25,26,27,28,29]
The analysis of genetic polymorphisms associated with ARHL would be more helpful in substantiating the causative relations of the risk factors for ARHL in the future
Summary
This study investigated the synergistic effects of risk factors on age-related hearing loss (ARHL) using nationwide cross-sectional data of 33,552 individuals from the 2010‒2013 Korea National Health and Nutrition Examination Survey. This study utilized the data of 33,552 individuals included in the nationwide annual report of the 2010‒2013 Korea National Health and Nutrition Examination Survey (KNHANES)[18] to identify the synergistic interrelationship between the risk factors for ARHL. Using this population-based cross-sectional data, we analyzed the odds ratio (OR) for each combination of modifiable risk factors for ARHL, in order to substantiate the deleterious combinatorial effects of these risk factors. For this analysis, as it substantially minimizes the collinearity of variables, which might be underestimated in the logistic regression model, and can be ideally applied to measure the accurately quantified OR of the combined risk factors for ARHL
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