Risk factors for hearing impairment among U.S. adults with diabetes: National Health and Nutrition Examination Survey 1999-2004

Abstract

Objective: The objective of this study was to examine the risk factors of low/mid-frequency and high-frequency hearing impairment among a nationally representative sample of diabetic adults.

Research design and methods: Data came from 536 participants, aged 20-69 years, with diagnosed or undiagnosed diabetes who completed audiometric testing during 1999-2004 in the National Health and Nutrition Examination Survey (NHANES). We defined hearing impairment as the pure-tone average>25 dB hearing level of pure-tone thresholds at low/mid-frequencies (500; 1,000; and 2,000 Hz) and high frequencies (3,000; 4,000; 6,000; and 8,000 Hz) and identified independent risk factors using logistic regression.

Results: Controlling for age, race/ethnicity, and marital status, odds ratios for associations with low/mid-frequency hearing impairment were 2.20 (95% CI 1.28-3.79) for HDL<40 mg/dL and 3.55 (1.57-8.03) for poor health. Controlling for age, race/ethnicity, sex, and income-to-poverty ratio, odds ratios for associations with high-frequency hearing impairment were 4.39 (1.26-15.26) for history of coronary heart disease and 4.42 (1.26-15.45) for peripheral neuropathy.

Conclusions: Low HDL, coronary heart disease, peripheral neuropathy, and having poor health are potentially preventable correlates of hearing impairment for people with diabetes. Glycemic control, years since diagnosis, and type of glycemic medication were not associated with hearing impairment.

Figure 1

A: Age-adjusted mean of pure-tone thresholds assessed in the worse ear among U.S. adults aged 20–69 years, by HDL status, NHANES 1999–2004. B: Age-adjusted mean of pure-tone thresholds assessed in the worse ear among U.S. adults aged 20–69 years, by coronary heart disease status, NHANES 1999–2004. C: Age-adjusted mean of pure-tone thresholds assessed in the worse ear among U.S. adults aged 40–69 years, by peripheral neuropathy status, NHANES 1999–2004. D: Age-adjusted mean of pure-tone thresholds assessed in the worse ear among U.S. adults aged 20–69 years, by self-reported health status, NHANES 1999–2004. (A high-quality color representation of this figure is available in the online issue.)