Introduction: In noise-induced hearing loss (NIHL), glutathione S-transferases (GSTs) play a pivotal role as antioxidants in cochlear protection. Nevertheless, the variability in population and environmental factors complicates the interpretation of research findings on the association among GST gene polymorphism, GST enzyme activity, and NIHL, leading to inconsistent results. To explore the potential correlation between them, we took a cross-sectional survey. Methods: For workers with NIHL, standard 1:1 propensity score matching was applied to create a highly comparable control group. Multiplex PCR was used to detect GSTT1 and GSTM1 gene deletions, PCR-restriction fragment length polymorphism was used to detect the GSTP1 rs1695 gene polymorphism, and a GST assay kit was used to measure total plasma GST activity. Furthermore, we analyzed the relationship among GST gene polymorphism, GST enzyme activity, and NIHL. Results: This study included 144 workers with NIHL and 144 workers with normal hearing. The GSTM1 null genotype was significantly higher among workers with NIHL than controls (64.6% vs. 49.3%), regression analysis revealed a significant correlation between GSTM1 null genotype and elevated susceptibility to NIHL (p = 0.013). Workers with NIHL had significantly lower GST activity than healthy controls (p < 0.05). GST enzymes were not affected by GSTT1, GSTM1, or GSTP1 polymorphisms. Conclusion: GSTM1 null genotype but not GSTM1 alone may confer susceptibility to NIHL, and serum GST enzyme activity is linked to NIHL.
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