Association between Anemia and Auditory Threshold Shifts in the US Population: National Health and Nutrition Examination Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Database
2.2. Study Participants Selection and Anemia Definition
2.3. Audiometric Measures
2.4. Auditory Threshold Shifts and Hearing Loss Definition
2.5. Covariate Measurement
2.6. Statistical Analysis
3. Results
4. Discussion
Limitations
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
- WHO. Addressing the Rising Prevalence of Hearing Loss; World Health Organization: Geneva, Switzerland, 2018.
- WHO. Global Costs of Unaddressed Hearing Loss and Cost-Effectiveness of Interventions: A Who Report, 2017; World Health Organization: Geneva, Switzerland, 2017.
- Goman, A.M.; Reed, N.S.; Lin, F.R. Addressing estimated hearing loss in adults in 2060. JAMA Otolaryngol. Head Neck Surg. 2017, 143, 733–734. [Google Scholar] [CrossRef]
- Rizzo, S.; Bentivegna, D.; Thomas, E.; La Mattina, E.; Mucia, M.; Salvago, P.; Sireci, F.; Martines, F. Sudden Sensorineural Hearing Loss, an Invisible Male: State of the Art; Nova Science Publishers, Inc.: New York, NY, USA, 2017. [Google Scholar]
- Mohammed, S.H.; Shab-Bidar, S.; Abuzerr, S.; Habtewold, T.D.; Alizadeh, S.; Djafarian, K. Association of anemia with sensorineural hearing loss: A systematic review and meta-analysis. BMC Res. Notes 2019, 12, 283. [Google Scholar] [CrossRef]
- Lago, M.R.R.; Fernandes, L.D.C.; Lyra, I.M.; Ramos, R.T.; Teixeira, R.; Salles, C.; Ladeia, A.M.T. Sensorineural hearing loss in children with sickle cell anemia and its association with endothelial dysfunction. Hematology 2018, 23, 849–855. [Google Scholar] [CrossRef] [Green Version]
- Chung, S.D.; Chen, P.Y.; Lin, H.C.; Hung, S.H. Sudden sensorineural hearing loss associated with iron-deficiency anemia: A population-based study. JAMA Otolaryngol. Head Neck Surg. 2014, 140, 417–422. [Google Scholar] [CrossRef] [Green Version]
- Schieffer, K.M.; Chuang, C.H.; Connor, J.; Pawelczyk, J.A.; Sekhar, D.L. Association of iron deficiency anemia with hearing loss in us adults. JAMA Otolaryngol. Head Neck Surg. 2017, 143, 350–354. [Google Scholar] [CrossRef] [Green Version]
- Schieffer, K.M.; Connor, J.R.; Pawelczyk, J.A.; Sekhar, D.L. The relationship between iron deficiency anemia and sensorineural hearing loss in the pediatric and adolescent population. Am. J. Audiol. 2017, 26, 155–162. [Google Scholar] [CrossRef]
- Aderibigbe, A.; Ologe, F.E.; Oyejola, B.A. Hearing thresholds in sickle cell anemia patients: Emerging new trends? J. Natl. Med. Assoc. 2005, 97, 1135–1142. [Google Scholar]
- Gates, G.A.; Mills, J.H. Presbycusis. Lancet 2005, 366, 1111–1120. [Google Scholar] [CrossRef]
- Beutler, E.; Waalen, J. The definition of anemia: What is the lower limit of normal of the blood hemoglobin concentration? Blood 2006, 107, 1747–1750. [Google Scholar] [CrossRef] [Green Version]
- Su, B.M.; Chan, D.K. Prevalence of hearing loss in us children and adolescents: Findings from nhanes 1988–2010. JAMA Otolaryngol. Head Neck Surg. 2017, 143, 920–927. [Google Scholar] [CrossRef]
- Lamm, K.; Arnold, W. The effect of blood flow promoting drugs on cochlear blood flow, perilymphatic po(2) and auditory function in the normal and noise-damaged hypoxic and ischemic guinea pig inner ear. Hear Res. 2000, 141, 199–219. [Google Scholar] [CrossRef]
- Shi, X. Physiopathology of the cochlear microcirculation. Hear Res. 2011, 282, 10–24. [Google Scholar] [CrossRef] [Green Version]
- Chang, Y.L.; Hung, S.H.; Ling, W.; Lin, H.C.; Li, H.C.; Chung, S.D. Association between ischemic stroke and iron-deficiency anemia: A population-based study. PLoS ONE 2013, 8, e82952. [Google Scholar] [CrossRef] [Green Version]
- Capaccio, P.; Ottaviani, F.; Cuccarini, V.; Bottero, A.; Schindler, A.; Cesana, B.M.; Censuales, S.; Pignataro, L. Genetic and acquired prothrombotic risk factors and sudden hearing loss. Laryngoscope 2007, 117, 547–551. [Google Scholar] [CrossRef]
- Marcucci, R.; Alessandrello Liotta, A.; Cellai, A.P.; Rogolino, A.; Berloco, P.; Leprini, E.; Pagnini, P.; Abbate, R.; Prisco, D. Cardiovascular and thrombophilic risk factors for idiopathic sudden sensorineural hearing loss. J. Thromb. Haemost. 2005, 3, 929–934. [Google Scholar] [CrossRef]
- Rudack, C.; Langer, C.; Stoll, W.; Rust, S.; Walter, M. Vascular risk factors in sudden hearing loss. Thromb. Haemost. 2006, 95, 454–461. [Google Scholar] [CrossRef] [PubMed]
- Chung, J.H.; Lee, S.H.; Park, C.W.; Kim, C.; Park, J.K.; Shin, J.H. Clinical significance of arterial stiffness in idiopathic sudden sensorineural hearing loss. Laryngoscope 2016, 126, 1918–1922. [Google Scholar] [CrossRef] [PubMed]
- Lopez, A.; Cacoub, P.; Macdougall, I.C.; Peyrin-Biroulet, L. Iron deficiency anaemia. Lancet 2016, 387, 907–916. [Google Scholar] [CrossRef]
- Camaschella, C. Iron-deficiency anemia. N. Engl. J. Med. 2015, 372, 1832–1843. [Google Scholar] [CrossRef] [Green Version]
- Zhang, C. Essential functions of iron-requiring proteins in DNA replication, repair and cell cycle control. Protein Cell 2014, 5, 750–760. [Google Scholar] [CrossRef] [Green Version]
- Badaracco, M.E.; Ortiz, E.H.; Soto, E.F.; Connor, J.; Pasquini, J.M. Effect of transferrin on hypomyelination induced by iron deficiency. J. Neurosci. Res. 2008, 86, 2663–2673. [Google Scholar] [CrossRef]
- Sprinzl, G.M.; Riechelmann, H. Current trends in treating hearing loss in elderly people: A review of the technology and treatment options—A mini-review. Gerontology 2010, 56, 351–358. [Google Scholar] [CrossRef]
- Ivory, R.; Kane, R.; Diaz, R.C. Noise-induced hearing loss: A recreational noise perspective. Curr. Opin. Otolaryngol. Head Neck Surg. 2014, 22, 394–398. [Google Scholar] [CrossRef]
- Tikka, C.; Verbeek, J.H.; Kateman, E.; Morata, T.C.; Dreschler, W.A.; Ferrite, S. Interventions to prevent occupational noise-induced hearing loss. Cochrane Database Syst. Rev. 2017, 7, CD006396. [Google Scholar] [CrossRef]
- Breglio, A.M.; Rusheen, A.E.; Shide, E.D.; Fernandez, K.A.; Spielbauer, K.K.; McLachlin, K.M.; Hall, M.D.; Amable, L.; Cunningham, L.L. Cisplatin is retained in the cochlea indefinitely following chemotherapy. Nat. Commun. 2017, 8, 1654. [Google Scholar] [CrossRef] [Green Version]
- Corbacella, E.; Lanzoni, I.; Ding, D.; Previati, M.; Salvi, R. Minocycline attenuates gentamicin induced hair cell loss in neonatal cochlear cultures. Hear Res. 2004, 197, 11–18. [Google Scholar] [CrossRef]
- Khan, A.S.; Sheikh, Z.; Khan, S.; Dwivedi, R.; Benjamin, E. Viagra deafness--sensorineural hearing loss and phosphodiesterase-5 inhibitors. Laryngoscope 2011, 121, 1049–1054. [Google Scholar] [CrossRef]
- Joo, Y.; Cruickshanks, K.J.; Klein, B.E.K.; Klein, R.; Hong, O.; Wallhagen, M. The contribution of ototoxic medications to hearing loss among older adults. J. Gerontol. A Biol. Sci. Med. Sci. 2019, 75, 561–566. [Google Scholar] [CrossRef] [Green Version]
Variable | Subjects with Anemia (n = 918) | Subjects without Anemia (n = 8213) | p Value | ||
---|---|---|---|---|---|
No. | % | No. | % | ||
Age Group (Years) | <0.001 | ||||
≤19 | 313 | 34.1 | 3675 | 44.8 | |
20–29 | 72 | 7.8 | 721 | 8.8 | |
30–39 | 73 | 8.0 | 664 | 8.1 | |
40–49 | 85 | 9.3 | 629 | 7.7 | |
50–59 | 68 | 7.4 | 673 | 8.2 | |
60–69 | 74 | 8.1 | 610 | 7.4 | |
≥70 | 233 | 25.4 | 1241 | 15.1 | |
Sex | <0.001 | ||||
Male | 367 | 40.0 | 4292 | 52.3 | |
Female | 551 | 60.0 | 3921 | 47.7 | |
Race | <0.001 | ||||
Non-Hispanic white | 224 | 24.4 | 3285 | 40.0 | |
Non-Hispanic black | 446 | 48.6 | 1871 | 22.8 | |
Other | 248 | 27.0 | 3057 | 37.2 | |
Ever had diagnosis | |||||
Hypertension | 329 | 35.8 | 1835 | 22.3 | <0.001 |
Diabetes | 128 | 13.9 | 570 | 6.9 | <0.001 |
Coronary heart disease | 44 | 4.8 | 212 | 2.6 | <0.001 |
Heart failure | 42 | 4.6 | 154 | 1.9 | <0.001 |
Stroke | 49 | 5.3 | 178 | 2.2 | <0.001 |
Variables | Total (n = 9131) | Subjects with Anemia (n = 918) | Subjects without Anemia (n = 8213) | p Value | |||
---|---|---|---|---|---|---|---|
n, % | n, % | n, % | |||||
Low-PTA (dB) | |||||||
Right Ear | 11.98 ± 12.58 | 15.04 ± 14.45 | 11.64 ± 12.31 | <0.001 | |||
Left Ear | 11.97 ± 12.71 | 15.57 ± 15.37 | 11.56 ± 12.31 | <0.001 | |||
High-PTA (dB) | |||||||
Right Ear | 19.08 ± 20.74 | 23.82 ± 23.06 | 18.55 ± 20.39 | <0.001 | |||
Left Ear | 20.04 ± 21.35 | 24.71 ± 23.80 | 19.51 ± 20.99 | <0.001 | |||
Hearing Loss | |||||||
HL | 5073 | 55.56 | 589 | 64.16 | 4484 | 54.60 | <0.001 |
LFHL | 3073 | 33.65 | 391 | 42.59 | 2682 | 32.66 | <0.001 |
HFHL | 4825 | 52.84 | 564 | 61.44 | 4261 | 51.88 | <0.001 |
Variables | Elderly Population (≥60 Years Old) | Adult Population (20–59 Years Old) | Adolescent Population (≤19 Years Old) | ||||||
---|---|---|---|---|---|---|---|---|---|
Subjects with Anemia (n = 307) | Subjects without Anemia (n = 1851) | p Value | Subjects with Anemia (n = 298) | Subjects without Anemia (n = 2687) | p Value | Subjects with Anemia (n = 313) | Subjects without Anemia (n = 3675) | p Value | |
Low-PTA (dB) | |||||||||
Right Ear | 28.07 ± 15.23 | 25.13 ± 15.32 | 0.002 | 9.93 ± 8.98 | 9.24 ± 9.15 | 0.213 | 7.14 ± 7.41 | 6.60 ± 6.15 | 0.212 |
Left Ear | 29.25 ± 16.49 | 25.01 ± 15.30 | <0.001 | 10.55 ± 10.09 | 9.21 ± 8.84 | 0.028 | 6.93 ± 6.90 | 6.51 ± 6.57 | 0.278 |
High-PTA (dB) | |||||||||
Right Ear | 48.20 ± 20.40 | 45.22 ± 21.57 | 0.024 | 15.44 ± 13.56 | 15.82 ± 14.30 | 0.231 | 7.88 ± 8.55 | 7.12 ± 7.16 | 0.129 |
Left Ear | 50.54 ± 20.50 | 47.00 ± 21.52 | 0.007 | 15.79 ± 13.05 | 16.98 ± 14.85 | 0.140 | 7.87 ± 8.57 | 7.52 ± 7.83 | 0.490 |
Hearing Loss | |||||||||
HL | 306 (99.67) | 1825 (98.60) | 0.163 | 185 (62.08) | 1655 (61.59) | 0.870 | 98 (31.31) | 1004 (27.32) | 0.130 |
LFHL | 268 (87.30) | 1494 (80.71) | 0.006 | 80 (26.85) | 717 (26.68) | 0.952 | 43 (13.74) | 471 (12.82) | 0.640 |
HFHL | 305 (99.35) | 1820 (98.33) | 0.216 | 178 (59.73) | 1606 (59.77) | 0.990 | 81 (25.88) | 835 (22.72) | 0.202 |
Models | Variables | High-PTA (dB) | Low-PTA (dB) | ||||||
---|---|---|---|---|---|---|---|---|---|
Right Ear | Left Ear | Right Ear | Left Ear | ||||||
β | p Value | β | p Value | β | p Value | β | p Value | ||
Model 1 a | All Patients with Anemia | 5.27 | <0.001 | 5.20 | <0.001 | 3.40 | <0.001 | 4.01 | <0.001 |
Elderly Patients with Anemia | 2.99 | 0.024 | 3.54 | 0.007 | 2.93 | 0.002 | 4.24 | <0.001 | |
Adult Patients with Anemia | −0.38 | 0.662 | −1.20 | 0.182 | 0.69 | 0.213 | 1.34 | 0.015 | |
Adolescent Patients with Anemia | 0.76 | 0.077 | 0.35 | 0.455 | 0.54 | 0.144 | 0.42 | 0.278 | |
Model 2 b | All Patients with Anemia c | 2.35 | <0.001 | 2.33 | <0.001 | 1.53 | <0.001 | 2.25 | <0.001 |
Elderly Patients with Anemia d | 3.76 | 0.002 | 4.03 | 0.001 | 3.55 | <0.001 | 4.64 | <0.001 | |
Adult Patients with Anemia d | 1.42 | 0.102 | 1.42 | 0.109 | 0.55 | 0.340 | 1.37 | 0.015 | |
Adolescent Patients with Anemia e | 0.79 | 0.073 | 0.59 | 0.210 | 0.65 | 0.085 | 0.77 | 0.053 |
© 2020 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Shih, J.-H.; Li, I.-H.; Pan, K.-T.; Wang, C.-H.; Chen, H.-C.; Fann, L.-Y.; Tseng, J.-H.; Kao, L.-T. Association between Anemia and Auditory Threshold Shifts in the US Population: National Health and Nutrition Examination Survey. Int. J. Environ. Res. Public Health 2020, 17, 3916. https://doi.org/10.3390/ijerph17113916
Shih J-H, Li I-H, Pan K-T, Wang C-H, Chen H-C, Fann L-Y, Tseng J-H, Kao L-T. Association between Anemia and Auditory Threshold Shifts in the US Population: National Health and Nutrition Examination Survey. International Journal of Environmental Research and Public Health. 2020; 17(11):3916. https://doi.org/10.3390/ijerph17113916
Chicago/Turabian StyleShih, Jui-Hu, I-Hsun Li, Ke-Ting Pan, Chih-Hung Wang, Hsin-Chien Chen, Li-Yun Fann, Jen-Ho Tseng, and Li-Ting Kao. 2020. "Association between Anemia and Auditory Threshold Shifts in the US Population: National Health and Nutrition Examination Survey" International Journal of Environmental Research and Public Health 17, no. 11: 3916. https://doi.org/10.3390/ijerph17113916