Correlation between Hearing Impairment and the Triglyceride Glucose Index in Middle-Aged Female Based on a Korean National Health and Nutrition Examination Survey
by
, , , , , , , , , and
Dong Oh Kim
1, 
Youngin Lee
1,*
,
Sang Yeoup Lee
1,2,3
,
Jeong Gyu Lee
2,4,
Yu Hyeon Yi
2,4,
Young Hye Cho
1,2
,
Young Jin Tak
2,4,
Eun Ju Park
1,
Seung Hun Lee
2,4,
Gyu Lee Kim
4,
Jung In Choi
1,
Young Jin Ra
4,
Sae Rom Lee
1,
Ryuk Jun Kwon
1,
Soo Min Son
1,
Su Min Lee
1 and
Jong Suk Lee
1 1
Department of Family Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
2
Department of Family Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
3
Department of Medical Education, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
4
Department of Family Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea
*
Author to whom correspondence should be addressed.
Medicina 2024, 60(10), 1596; https://doi.org/10.3390/medicina60101596 (registering DOI)
Submission received: 22 August 2024
/
Revised: 23 September 2024
/
Accepted: 26 September 2024
/
Published: 28 September 2024
(This article belongs to the Section Epidemiology & Public Health)
Abstract
:Background and Objectives: This study aimed to investigate the association between insulin resistance, as measured by the triglyceride–glucose index (TyG index), and hearing impairment in middle-aged women in Korea. Materials and Methods: This cross-sectional survey utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2007–2009), specifically from the period after July 21, 2009, when hearing test results became available, and from the KNHANES V (2010–2012). This study was conducted on 5416 women aged 40 to 69 who had completed both the health examination survey and audiometric tests, excluding those with missing data on menopausal status and the use of hormone replacement therapy. Results: In the study group, the prevalence of high-frequency hearing loss according to the TyG index was significantly higher in the mild hearing loss group (OR = 1.29; 95% CI: 1.12, 1.49, p < 0.001) and the moderate hearing loss group (OR = 1.27; 95% CI: 1.09, 1.48, p = 0.002). Conversely, the prevalence of low-frequency hearing loss did not show a significant difference in either the mild hearing loss group (OR = 1.17; 95% CI: 0.99, 1.37, p = 0.065) and the moderate hearing loss group (OR = 1.13; 95% CI: 0.94, 1.35, p = 0.199) Conclusions: Since diabetes can induce hearing impairment in women, it is recommended that women with a high TyG index undergo early hearing tests
1. Introduction
Hearing impairment is one of the major disabilities [1] yet hearing loss screenings are not properly conducted in daily life. Many people are unaware of the need for hearing screenings and believe that the cost is high. This makes it difficult to administer timely treatment [2].
There are various causes of hearing loss, including presbycusis, noise exposure, ototoxic drugs, and viral infections [3]. Presbycusis is a common chronic condition among the elderly, and diabetes has been reported to exacerbate age-related hearing loss [4] and is also recognized as an independent factor for hearing loss regardless of age [5].
Diabetes can cause vascular diseases and neurological complications in the long term [6]. Recent studies have suggested that hearing loss is a new complication of diabetes. Numerous studies and large-scale meta-analyses have found a significant association between diabetes and sensorineural hearing loss [5,6,7,8,9].
The mechanisms by which diabetes induces hearing loss include microangiopathy, advanced glycation end products, and oxidative stress pathways [10]. Although the exact mechanisms are still unclear, hyperglycemia is known to damage the microvascular structure of the inner ear tissues, impair oxygen supply, and cause demyelination of the auditory nerve and loss of spiral ganglion cells and outer hair cells [11,12]. HOMA-IR is used to evaluate insulin resistance in diabetes, and there are studies investigating the association between HOMA-IR, impaired fasting glucose (IFG), and hearing loss [13]. While HOMA-IR is widely used as a non-invasive method to study insulin resistance, its value diminishes in patients undergoing insulin treatment or those lacking functional β-cells [14]. Therefore, there is a need for new methods to assess insulin resistance, and the TyG index can be used instead of HOMA-IR [15]. Research has shown that the TyG index can more robustly predict various complications such as cardiovascular diseases [16], type 2 diabetes [17], and polycystic ovary syndrome [18], and it is easier to apply in clinical practice [19]. Due to insulin resistance primarily affecting high-frequency hearing loss [13], this study also distinguishes between high-frequency and low-frequency hearing loss. Additionally, there are studies on the correlation between the TyG index and hearing loss, but these studies have the limitation of being based on the NHANES cohort, making it difficult to apply their findings to the Korean population [20].
Estrogen has been found to influence hearing protection positively, whereas progestin has a negative impact on hearing [21]. There are also studies suggesting that hormone replacement therapy helps reduce hearing loss [22]. Therefore, in studies on hearing loss in women, it is necessary to account for menopause status and hormone replacement therapy use. However, to date, no studies have adjusted for hormone replacement therapy when examining the association between the TyG index and hearing loss. This study investigated the association between the TyG index and hearing loss in a representative sample of Korean women aged 40–69, adjusting for menopause status and hormone replacement therapy use.
2. Materials and Methods
2.1. Study Subjects
This cross-sectional survey utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2007–2009), which has been conducted periodically by the Ministry of Health and Welfare of South Korea since 1998. Specifically, this study utilized data from July 21, 2009, when hearing test results became available, and from the KNHANES V (2010–2012). A total of 36,067 individuals completed the survey during this period. This study focused on women aged 40–69 years, excluding those with missing data on menopause status and hormone replacement therapy usage, and included only those who completed both the health examination survey and audiometric test (n = 5416). The survey design was reviewed by the Institutional Review Board of the Korea Centers for Disease Control and Prevention (2009-01CON-03-2C, 2010-02CON-21-C, 2011-02CON-06-C, 2012-01EXP-01-2C).
2.2. Laboratory Tests
During the survey, overnight fasting blood samples were collected from all participants in the morning. These samples were immediately refrigerated and transported to a central testing laboratory in Seoul, South Korea. All blood samples were analyzed within 24 h of transportation. Fasting triglyceride and fasting glucose levels were measured, and the TyG index was calculated using the following formula:
2.3. Audiometric Tests
Trained otolaryngologists conducted pure-tone audiometry at six frequencies (500, 1000, 2000, 3000, 4000, and 6000 Hz) for each ear using a GSI SA-203 automatic audiometer manufactured by Entomed Diagnostics AB, Malmö, Sweden, in a soundproof booth. Hearing impairment was classified into low-/high-frequency and mild/moderate categories. The low-frequency pure-tone average (PTA) was defined as the mean hearing threshold at 500, 1000, and 2000 Hz for each ear. The high-frequency PTA was defined as the mean hearing threshold at 3000, 4000, and 6000 Hz for each ear. Mild hearing impairment was defined as an unaided pure-tone average of 26–40 dB in the better ear. Moderate hearing impairment was defined as an unaided pure-tone average of ≥40 dB in the better ear.
2.4. Prevalence of Hearing Loss
The prevalence of hearing loss was calculated as the point prevalence based on data from the Korean National Health and Nutrition Examination Survey (KNHANES). It was determined as the proportion of participants who met the hearing impairment criteria described in Section 2.3 among the participants targeted in this study, as described in Section 2.1 (n = 5416).
2.5. Statistical Analysis
The distribution of demographic, socioeconomic, and clinical characteristics was analyzed using the chi-squared test and one-way ANOVA. The association between the TyG index and the prevalence of hearing impairment was assessed using multivariable logistic regression analysis. After adjusting for menopausal status, hormone replacement therapy use, smoking, income, education level, and alcohol consumption, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Statistical analyses were performed using SPSS version 27.0.
3. Results
The basic characteristics of the study population according to the presence of hearing loss are shown in Table 1 and Table 2. A total of 5416 female participants aged 40 to 69 years were selected, and the proportions of normal hearing, mild hearing loss, and severe hearing loss in the high-frequency range were presented according to various variables. The mean ages for the normal, mild hearing loss, and moderate hearing loss groups were 48.70 ± 0.16, 54.72 ± 0.25, and 57.77 ± 0.29, respectively. Characteristics affecting high-frequency hearing loss included age, alcohol consumption, income level, education level, menopause status, and use of female hormones (p < 0.01). Smoking did not influence high-frequency hearing loss (p = 0.297).
Characteristics influencing low-frequency hearing loss included age, alcohol consumption, income level, education level, and menopause status (p < 0.01). Smoking (p = 0.893) and hormone replacement therapy (p = 0.21) did not affect low-frequency hearing loss.
3.1. Prevalence of Hearing Loss According to the TyG Index
The prevalence of high-frequency hearing loss increased with higher TyG index values. As shown in Table 3, in the crude model, high-frequency hearing loss was observed in the mild group (OR = 1.38; 95% CI: 1.38, 1.83, p < 0.001) and the moderate group (OR = 1.68; 95% CI: 1.46, 1.94, p < 0.001).
The prevalence of low-frequency hearing loss increased with higher index values. As shown in Table 4, in the crude model, low-frequency hearing loss was observed in the mild hearing loss group (OR = 1.44; 95% CI: 1.23, 1.67, p < 0.001) and in the moderate hearing loss group (OR = 1.38; 95% CI: 1.16, 1.64, p < 0.001).
3.2. Prevalence of Hearing Loss According to the TyG Index after Adjusting for Variables
In Model 2, after adjusting for menopausal status, hormone replacement therapy use, smoking, income, education level, and alcohol consumption, a higher TyG index was associated with a significantly increased risk of high-frequency hearing loss. Specifically, participants with higher TyG index values had a higher prevalence of high-frequency hearing loss, both in the mild hearing loss group (OR = 1.29; 95% CI: 1.12, 1.49, p < 0.001) and the moderate hearing loss group (OR = 1.27; 95% CI: 1.09, 1.48, p = 0.002).
Conversely, the association between the TyG index and low-frequency hearing loss was not significant in either the mild hearing loss group (OR = 1.17; 95% CI: 0.99, 1.37, p = 0.065) and the moderate hearing loss group (OR = 1.13; 95% CI: 0.94, 1.35, p = 0.199).
4. Discussion
In this study, a high TyG index is an independent risk factor for hearing impairment in Korean women aged 40–69, even after adjusting for several variables. Diabetes mellitus is known to be associated with hearing impairment, and the TyG index may be used to predict diabetes. Previous studies have investigated the impact of IFG and diabetes on hearing impairment using HOMA-IR in a Korean population [13]. In that study, significant associations between IFG, HOMA-IR, HOMA-b, and hearing impairment were observed only in men, consistent with prior research [8,23]. On the other hand, this study suggests that insulin resistance, as measured by the TyG index, may be associated with high-frequency hearing loss in women, after adjusting for menopausal status and hormone replacement therapy.
Although diabetes mellitus is a well-established risk factor for hearing impairment, the exact mechanisms through which diabetes induces hearing impairment remain unclear [24]. Microvascular disease and peripheral neuropathy resulting from diabetes have been suggested as contributing factors to hearing impairment [25,26]. One study reported that auditory dysfunction related to peripheral neuropathy is mainly associated with chronic hyperglycemia rather than acute hyperglycemia [27]. This highlights the potential significance of the TyG index in patients with diabetes. Studies testing insulin resistance using the TyG index have demonstrated that it is superior to the HOMA-IR index due to its insulin independence [19,28,29].
Previous research has indicated that estradiol has a protective effect on hearing [30,31], but some studies [32] have reported that oral estradiol increases the risk of hearing loss in postmenopausal women, with the duration of oral estradiol use being significantly associated with the risk of hearing impairment. Meanwhile, nearly all researchers agree that progesterone can cause hearing loss [32,33], being linked to increased vascular inflammation in the inner ear [34].
The strengths of this study are its focus on a representative sample of the general female population in Korea and a relatively large sample size. However, this study has some limitations. First, as this study is cross-sectional, this study does not fully establish causality between insulin resistance and hearing loss in women. Additional longitudinal studies are required to verify this. Second, there are missing data on menopausal status and hormone therapy use in the KNHANES dataset, and there was no survey on the types, dosage, and duration of hormone therapy use. Further research should control for the types, dosage, and duration of hormone therapy use.
Age-related hearing loss can begin as early as 40–50 years old, initially affecting high-frequency hearing and subsequently impacting low-frequency hearing [35]. Diabetic patients under 60 years old show early high-frequency hearing impairment, and the difference in hearing loss between diabetic and non-diabetic individuals decreases thereafter [36].
5. Conclusions
Since diabetes can induce hearing impairment in women, it is recommended that early hearing tests be conducted for women with a high TyG index to screen for potential hearing loss.
Author Contributions
Conceptualization, Y.L. and E.J.P.; Methodology, Y.H.C. and J.I.C.; Validation, Y.J.T. and Y.J.R.; Formal analysis, Y.H.Y. and S.M.S.; Investigation, S.M.L. and J.S.L.; Resources, G.L.K.; Data curation, R.J.K.; writing—original draft, D.O.K.; writing—review & editing, Y.L., S.Y.L., J.G.L., S.H.L., Y.J.R., S.R.L. and R.J.K.; Supervision, Y.L. and S.Y.L.; Project administration, J.G.L.; All authors have read and agreed to the published version of the manuscript.
Funding
This study was supported by a 2024 research grant from Pusan National University Yangsan Hospital.
Institutional Review Board Statement
The survey design was reviewed by the Institutional Review Board of the Korea Centers for Disease Control and Prevention (2009-01CON-03-2C, 2010-02CON-21-C, 2011-02CON-06-C, 2012-01EXP-01-2C); ethical approved date: 2009: 2009-01CON-03-2C (14 April 2009); 2010: 2010-02CON-21-C (22 April 2010); 2011: 2011-02CON-06-C (3 March 2011); 2012: 2012-01EXP-01-2C (11 January 2012).
Informed Consent Statement
All KNHANES participants were notified that they had been randomly selected for the survey and were given the option to participate in further analyses. Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
Data and materials are available upon reasonable request. The raw KNHANES data used in this paper can be accessed via the following website: https://knhanes.kdca.go.kr/knhanes/sub03/sub03_02_05.do (accessed on 15 August 2024).
Conflicts of Interest
The authors declare no conflicts of interest.
References
- Vos, T.; Allen, C.; Arora, M.; Barber, R.M.; Bhutta, Z.A. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: A systematic analysis for the global burden of disease study 2015. Lancet 2016, 388, 1545–1602. [Google Scholar] [CrossRef]
- Cunningham, L.L.; Tucci, D.L. Hearing loss in adults. N. Engl. J. Med. 2017, 377, 2465–2473. [Google Scholar] [CrossRef]
- Yueh, B.; Shapiro, N.; MacLean, C.H.; Shekelle, P.G. Screening and management of adult hearing loss in primary care: Scientific review. JAMA 2003, 289, 1976–1985. [Google Scholar] [CrossRef]
- Rozanska-Kudelska, M.; Chodynicki, S.; Kinalska, I.; Kowalska, I. Hearing loss in patients with diabetes mellitus type II. Otolaryngol. Pol. Pol. Otolaryngol. 2002, 56, 607–610. [Google Scholar]
- Horikawa, C.; Kodama, S.; Tanaka, S.; Fujihara, K.; Hirasawa, R.; Yachi, Y.; Shimano, H.; Yamada, N.; Saito, K.; Sone, H. Diabetes and risk of hearing impairment in adults: A meta-analysis. J. Clin. Endocrinol. Metab. 2013, 98, 51–58. [Google Scholar] [CrossRef]
- Vijan, S. Type 2 diabetes. Ann. Intern. Med. 2010, 152, ITC31-15. [Google Scholar] [CrossRef]
- Oh, I.-H.; Lee, J.H.; Park, D.C.; Kim, M.; Chung, J.H.; Kim, S.H.; Yeo, S.G. Hearing loss as a function of aging and diabetes mellitus: A cross sectional study. PLoS ONE 2014, 9, e116161. [Google Scholar] [CrossRef]
- Hong, J.W.; Jeon, J.H.; Ku, C.R.; Noh, J.H.; Yoo, H.J.; Kim, D.J. The prevalence and factors associated with hearing impairment in the Korean adults: The 2010–2012 Korea National Health and Nutrition Examination Survey (observational study). Medicine 2015, 94, e611. [Google Scholar] [CrossRef]
- Frisina, S.T.; Mapes, F.; Kim, S.; Frisina, D.R.; Frisina, R.D. Characterization of hearing loss in aged type II diabetics. Hear. Res. 2006, 211, 103–113. [Google Scholar] [CrossRef]
- Hong, O.; Buss, J.; Thomas, E. Type 2 diabetes and hearing loss. Dis. Mon. 2013, 59, 139–146. [Google Scholar] [CrossRef]
- Fukushima, H.; Cureoglu, S.; Schachern, P.A.; Paparella, M.M.; Harada, T.; Oktay, M.F. Effects of type 2 diabetes mellitus on cochlear structure in humans. Arch. Otolaryngol. Head Neck Surg. 2006, 132, 934–938. [Google Scholar] [CrossRef]
- McQueen, C.T.; Baxter, A.; Smith, T.L.; Raynor, E.; Yoon, S.M.; Prazma, J.; Pillsbury, H.C. Non-insulin-dependent diabetic microangiopathy in the inner ear. J. Laryngol. Otol. 1999, 113, 13–18. [Google Scholar] [CrossRef]
- Seo, M.; Lee, Y.S.; Moon, S.S. Association of hearing impairment with insulin resistance, β-cell dysfunction and impaired fasting glucose before onset of diabetes. Diabet. Med. 2016, 33, 1275–1282. [Google Scholar] [CrossRef] [PubMed]
- Van Minh, H.; Tien, H.A.; Sinh, C.T.; Thang, D.C.; Chen, C.; Tay, J.C.; Siddique, S.; Wang, T.; Sogunuru, G.P.; Chia, Y.; et al. Assessment of preferred methods to measure insulin resistance in Asian patients with hypertension. J. Clin. Hypertens. 2021, 23, 529–537. [Google Scholar] [CrossRef]
- Son, D.H.; Lee, H.S.; Lee, Y.J.; Lee, J.H.; Han, J.H. Comparison of triglyceride-glucose index and HOMA-IR for predicting prevalence and incidence of metabolic syndrome. Nutr. Metab. Cardiovasc. Dis. 2022, 32, 596–604. [Google Scholar] [CrossRef] [PubMed]
- Tao, L.C.; Xu, J.N.; Wang, T.T.; Hua, F.; Li, J.J. Triglyceride-glucose index as a marker in cardiovascular diseases: Landscape and limitations. Cardiovasc. Diabetol. 2022, 21, 68. [Google Scholar] [CrossRef] [PubMed]
- Park, H.M.; Lee, H.S.; Lee, Y.J.; Lee, J.H. The triglyceride-glucose index is a more powerful surrogate marker for predicting the prevalence and incidence of type 2 diabetes mellitus than the homeostatic model assessment of insulin resistance. Diabetes Res. Clin. Pract. 2021, 180, 109042. [Google Scholar] [CrossRef]
- Zhang, L.; Wang, H.; Ma, Q.; Liu, Y.; Chen, A.; Lu, J.; Ren, L. Value of the triglyceride glucose index and non-traditional blood lipid parameters in predicting metabolic syndrome in women with polycystic ovary syndrome. Hormones 2023, 22, 263–271. [Google Scholar] [CrossRef]
- Simental-Mendía, L.E.; Rodríguez-Morán, M.; Guerrero-Romero, F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab. Syndr. Relat. Disord. 2008, 6, 299–304. [Google Scholar] [CrossRef]
- Liu, L.; Qin, M.; Ji, J.; Wang, W. Correlation between hearing impairment and the Triglyceride Glucose Index: Based on a national cross-sectional study. Front. Endocrinol. 2023, 14, 1216718. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Kilicdag, E.B.; Yavuz, H.; Bagis, T.; Tarim, E.; Erkan, A.N.; Kazanci, F. Effects of estrogen therapy on hearing in postmenopausal women. Am. J. Obstet. Gynecol. 2004, 190, 77–82. [Google Scholar] [CrossRef] [PubMed]
- Lien, K.H.; Yang, C.H. Sex Differences in the Triad of Acquired Sensorineural Hearing Loss. Int. J. Mol. Sci. 2021, 22, 8111. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Cruickshanks, K.J.; Dhar, S.; Dinces, E.; Fifer, R.C.; Gonzalez, F.; Heiss, G.; Hoffman, H.J.; Lee, D.J.; Newhoff, M.; Tocci, L.; et al. Hearing impairment prevalence and associated risk factors in the Hispanic community health study/study of Latinos. JAMA Otolaryngol. Head Neck Surg. 2015, 141, 641–648. [Google Scholar] [CrossRef] [PubMed]
- Samocha-Bonet, D.; Wu, B.; Ryugo, D.K. Diabetes mellitus and hearing loss: A review. Ageing Res. Rev. 2021, 71, 101423. [Google Scholar] [CrossRef]
- Agrawal, Y.; Carey, J.P.; Della Santina, C.C.; Schubert, M.C.; Minor, L.B. Diabetes, vestibular dysfunction, and falls: Analyses from the national health and nutrition examination survey. Otol. Neurotol. 2010, 31, 1445–1450. [Google Scholar] [CrossRef]
- Fukushima, H.; Cureoglu, S.; Schachern, P.A.; Kusunoki, T.; Oktay, M.F.; Fukushima, N.; Paparella, M.M.; Harada, T. Cochlear changes in patients with type 1 diabetes mellitus. Otolaryngol. Head Neck Surg. 2005, 133, 100–106. [Google Scholar] [CrossRef] [PubMed]
- Sasso, F.C.; Salvatore, T.; Tranchino, G.; Cozzolino, D.; Caruso, A.A.; Persico, M.; Gentile, S.; Torella, D.; Torella, R. Cochlear dysfunction in type 2 diabetes: A complication independent of neuropathy and acute hyperglycemia. Metabolism 1999, 48, 1346–1350. [Google Scholar] [CrossRef] [PubMed]
- Vasques, A.C.J.; Novaes, F.S.; de Oliveira, M.D.S.; Souza, J.R.M.; Yamanaka, A.; Pareja, J.C.; Tambascia, M.A.; Saad, M.J.A.; Geloneze, B. TyG index performs better than HOMA in a Brazilian population: A hyperglycemic clamp validated study. Diabetes Res. Clin. Pract. 2011, 93, e98–e100. [Google Scholar] [CrossRef]
- Dhanda, N.; Taheri, S. A narrative review of obesity and hearing loss. Int. J. Obes. 2017, 41, 1066–1073. [Google Scholar] [CrossRef]
- Shuster, B.; Casserly, R.; Lipford, E.; Olszewski, R.; Milon, B.; Viechweg, S.; Davidson, K.; Enoch, J.; McMurray, M.; Rutherford, M.A.; et al. Estradiol protects against noise-induced hearing loss and modulates auditory physiology in female mice. Int. J. Mol. Sci. 2021, 22, 12208. [Google Scholar] [CrossRef]
- Khaliq, F.; Tandon, O.P.; Goel, N. Differential effects of exogenous estrogen versus a estrogen-progesterone combination on auditory evoked potentials in menopausal women. Indian J. Physiol. Pharmacol. 2005, 49, 345–352. [Google Scholar] [PubMed]
- Curhan, S.G.; Eliassen, A.H.; Eavey, R.D.; Wang, M.; Lin, B.M.; Curhan, G.C. Menopause and postmenopausal hormone therapy and risk of hearing loss. Menopause 2017, 24, 1049–1056. [Google Scholar] [CrossRef] [PubMed]
- Bonnard, A.; Sahlin, L.; Hultcrantz, M.; Simonoska, R. No direct nuclear effect of progesterone in the inner ear: Other possible pathways. Acta Otolaryngol. 2013, 133, 1250–1257. [Google Scholar] [CrossRef]
- Bittar, R.S.; Cruz, O.L.; Lorenzi, M.C.; Marone, S.A.; Miniti, A. Morphological and functional study of the cochlea after administration of estrogen and progesterone in the guinea pig. Int. Tinnitus J. 2001, 7, 41–45. [Google Scholar]
- Roeser, R.J.; Valente, M.; Hosford-Dunn, H. Diagnostic proceduresin the profession of audiology. In Audiology Diagnosis; Roeser, R.J., Valente, M., Hosford-Dunn, H., Eds.; Thieme: New York, NY, USA, 2000. [Google Scholar]
- Vaughan, N.; James, K.; McDermott, D.; Griest, S.; Fausti, S. A 5-year prospective study of diabetes and hearing loss in a veteran population. Otol. Neurotol. 2006, 27, 37–43. [Google Scholar] [CrossRef]
Table 1.
General characteristics of study subjects with high-frequency hearing loss.
| Normal | Mild | Moderate | |||
|---|---|---|---|---|---|
| Total no. subjects | 2652 | 1495 | 1269 | ||
| Variable | Category | M ± SE/n(%) | M ± SE/n(%) | M ± SE/n(%) | p |
| Age | Year | 48.70 ± 0.16 | 54.72 ± 0.25 | 57.77 ± 0.29 | <0.001 |
| Smoking | Less than 5P | 26(1.2) | 12(0.6) | 13(1.4) | 0.297 |
| More than 5P | 155(6.8) | 102(8.1) | 66(6.3) | ||
| No smoking | 2471(92.0) | 1381(91.3) | 1190(92.3) | ||
| Drinking (1Y) | No (1Y) | 442(16.0) | 239(15.8) | 213(17.3) | <0.001 |
| Less than 1 in Month | 746(28.8) | 399(27.6) | 332(26.0) | ||
| 1 in month | 358(13.6) | 149(10.2) | 128(11.1) | ||
| 2–4 in month | 458(17.7) | 223(15.5) | 157(14.5) | ||
| 2–3 in week | 159(6.5) | 85(7.3) | 44(4.5) | ||
| More than 4 in week | 52(2.2) | 23(1.9) | 24(1.8) | ||
| No drinking | 437(15.4) | 377(21.7) | 371(24.8) | ||
| Income | Lower | 253(9.7) | 317(18.6) | 379(26.9) | <0.001 |
| Lower-middle | 613(25.4) | 405(27.7) | 380(28.7) | ||
| Upper-middle | 775(29.6) | 393(27.6) | 271(24.2) | ||
| Upper | 1011(35.3) | 380(26.1) | 239(20.2) | ||
| Education level | Elementary school or below | 326(11.3) | 473(29.0) | 580(42.6) | <0.001 |
| Highschool graduate or below | 1769(69.0) | 906(64.0) | 632(53.1) | ||
| College graduate or above | 557(19.8) | 116(7.0) | 57(4.3) | ||
| Menopausal status | No | 1625(67.0) | 512(40.1) | 365(34.8) | <0.001 |
| Yes | 1027(33.0) | 983(59.9) | 904(65.2) | ||
| Hormone replacement therapy | No | 292(9.3) | 263(14.9) | 234(15.9) | <0.001 |
| Yes | 2360(90.7) | 1232(85.1) | 1035(84.1) | ||
| BMI | 23.80 ± 0.08 | 24.34 ± 0.13 | 24.26 ± 0.11 | <0.001 | |
| SBP | 116.86 ± 0.40 | 121.35 ± 0.57 | 124.08 ± 0.70 | <0.001 | |
| DBP | 75.99 ± 0.24 | 77.02 ± 0.32 | 76.90 ± 0.38 | 0.011 | |
| Total cholesterol | 194.45 ± 0.83 | 198.39 ± 1.04 | 199.77 ± 1.34 | <0.001 | |
| HDL | 52.21 ± 0.27 | 50.01 ± 0.37 | 49.29 ± 0.39 | <0.001 | |
| Triglyceride | 114.07 ± 2.36 | 133.02 ± 2.79 | 133.98 ± 3.06 | <0.001 | |
| eGFR | 101.08 ± 0.30 | 97.09 ± 0.38 | 95.50 ± 0.47 | <0.001 | |
| Hypertension | Yes | 416(14.2) | 413(24.4) | 461(34.1) | <0.001 |
| Hyperlipidemia | Yes | 342(11.2) | 264(15.2) | 245(17.5) | <0.001 |
| TyG_Index | 8.44 ± 0.01 | 8.61 ± 0.02 | 8.63 ± 0.02 | <0.001 |
Values are presented as mean ± standard deviation or number (%).
Table 2.
General characteristics of study subjects with low-frequency hearing loss.
| Normal | Mild | Moderate | |||
|---|---|---|---|---|---|
| Total no. subjects | 4048 | 845 | 523 | ||
| Variable | Category | M ± SE/n(%) | M ± SE/n(%) | M ± SE/n(%) | p |
| Age | Year | 50.70 ± 0.15 | 57.09 ± 0.37 | 57.19 ± 0.46 | <0.001 |
| Smoking | Less than 5P | 40(1.2) | 7(0.8) | 4(0.9) | 0.893 |
| More than 5P | 241(7.0) | 51(7.7) | 31(6.9) | ||
| No smoking | 3767(91.9) | 787(91.6) | 488(92.2) | ||
| Drinking (1Y) | No (1Y) | 663(15.8) | 134(16.8) | 97(19.0) | <0.001 |
| Less than 1 in Month | 1139(29.0) | 221(25.1) | 117(22.5) | ||
| 1 in month | 495(12.4) | 86(11.8) | 54(10.6) | ||
| 2–4 in month | 662(17.0) | 107(14.2) | 69(14.7) | ||
| 2–3 in week | 235(6.8) | 31(4.5) | 22(4.9) | ||
| More than 4 in week | 68(1.9) | 20(2.2) | 11(2.7) | ||
| No drinking | 786(17.1) | 246(25.4) | 153(25.6) | ||
| Income | Lower | 558(12.7) | 237(25.5) | 154(25.0) | <0.001 |
| Lower-middle | 1006(26.1) | 248(30.4) | 144(26.7) | ||
| Upper-middle | 1140(29.2) | 178(21.4) | 121(27.2) | ||
| Upper | 1344(32.0) | 182(22.7) | 104(21.1) | ||
| Education level | Elementary school or below | 791(17.1) | 368(41.5) | 220(39.4) | <0.001 |
| Highschool graduate or below | 2602(67.4) | 425(52.3) | 280(56.7) | ||
| College graduate or above | 655(15.5) | 52(6.3) | 23(3.8) | ||
| Menopausal status | No | 2080(58.1) | 242(35.3) | 180(38.7) | <0.001 |
| Yes | 1968(41.9) | 603(64.7) | 343(61.3) | ||
| Hormone replacement therapy | No | 547(11.4) | 148(14.1) | 94(15.5) | 0.021 |
| Yes | 3501(88.6) | 697(85.9) | 429(84.5) | ||
| BMI | 23.99 ± 0.07 | 24.24 ± 0.14 | 24.13 ± 0.17 | 0.125 | |
| SBP | 118.51 ± 0.35 | 122.11 ± 0.79 | 124.41 ± 1.13 | <0.001 | |
| DBP | 76.44 ± 0.21 | 76.21 ± 0.43 | 76.88 ± 0.56 | 0.510 | |
| Total cholesterol | 196.01 ± 0.67 | 198.30 ± 1.49 | 198.89 ± 1.79 | 0.091 | |
| HDL | 51.50 ± 0.22 | 48.90 ± 0.49 | 50.18 ± 0.63 | <0.001 | |
| Triglyceride | 120.40 ± 1.88 | 133.43 ± 3.58 | 131.40 ± 4.38 | <0.001 | |
| eGFR | 99.73 ± 0.26 | 95.66 ± 0.58 | 96.43 ± 0.63 | <0.001 | |
| Hypertension | Yes | 807(17.5) | 286(31.0) | 197(35.3) | <0.001 |
| Hyperlipidemia | Yes | 573(12.4) | 176(17.6) | 102(17.4) | 0.001 |
| TyG_Index | 8.49 ± 0.01 | 8.63 ± 0.03 | 8.62 ± 0.03 | <0.001 |
Table 3.
High-frequency hearing loss according to the TyG index.
| HFHL (Ref: Normal) | Crude Model | Adjusted Model 1 | Adjusted Model 2 | ||||||
|---|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | |
| Mild | 1.59 | 1.38, 1.83 | <0.001 | 1.41 | 1.22, 1.62 | <0.001 | 1.29 | 1.12, 1.49 | <0.001 |
| Moderate | 1.68 | 1.46, 1.94 | <0.001 | 1.46 | 1.26, 1.69 | <0.001 | 1.27 | 1.09, 1.48 | 0.002 |
Adjusted Model 1: menopausal status and hormone replacement therapy; Adjusted Model 2: model 1 + smoking, income, education level, and alcohol consumption.
Table 4.
Low-frequency hearing loss according to the TyG index.
| LFHL (Ref: Normal) | Crude Model | Adjusted Model 1 | Adjusted Model 2 | ||||||
|---|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | |
| Mild | 1.44 | 1.23, 1.67 | <0.001 | 1.29 | 1.10, 1.51 | 0.002 | 1.17 | 0.99, 1.37 | 0.065 |
| Moderate | 1.38 | 1.16, 1.64 | <0.001 | 1.26 | 1.06, 1.49 | 0.010 | 1.13 | 0.94, 1.35 | 0.199 |
Adjusted model 1: menopausal status and hormone replacement therapy; Adjusted Model 2: model 1 + smoking, income, education level, and alcohol consumption.
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© 2024 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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MDPI and ACS Style
Kim, D.O.; Lee, Y.; Lee, S.Y.; Lee, J.G.; Yi, Y.H.; Cho, Y.H.; Tak, Y.J.; Park, E.J.; Lee, S.H.; Kim, G.L.; et al. Correlation between Hearing Impairment and the Triglyceride Glucose Index in Middle-Aged Female Based on a Korean National Health and Nutrition Examination Survey. Medicina 2024, 60, 1596. https://doi.org/10.3390/medicina60101596
AMA Style
Kim DO, Lee Y, Lee SY, Lee JG, Yi YH, Cho YH, Tak YJ, Park EJ, Lee SH, Kim GL, et al. Correlation between Hearing Impairment and the Triglyceride Glucose Index in Middle-Aged Female Based on a Korean National Health and Nutrition Examination Survey. Medicina. 2024; 60(10):1596. https://doi.org/10.3390/medicina60101596
Chicago/Turabian StyleKim, Dong Oh, Youngin Lee, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Hye Cho, Young Jin Tak, Eun Ju Park, Seung Hun Lee, Gyu Lee Kim, and et al. 2024. "Correlation between Hearing Impairment and the Triglyceride Glucose Index in Middle-Aged Female Based on a Korean National Health and Nutrition Examination Survey" Medicina 60, no. 10: 1596. https://doi.org/10.3390/medicina60101596
