Association between body roundness index and hearing loss in the United States population: A cross-sectional study

Hearing loss represents a significant public health concern, with obesity increasingly recognized as a potential risk factor. The body roundness index (BRI) is a novel anthropometric measure that more accurately reflects body fat distribution in comparison to conventional obesity indices. Nevertheless, the relationship between BRI and hearing loss remains to be elucidated. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey to investigate the relationship between BRI and hearing loss in United States adults. Hearing loss was categorized into low frequency, high frequency, and speech-frequency categories based on audiometric testing. The association between BRI and hearing impairment was then assessed using a range of analytical approaches, including logistic regression models, restricted cubic spline analysis, and machine learning methods (least absolute shrinkage and selection operator, random forest, and eXtreme Gradient Boosting). Higher BRI was significantly associated with increased odds of hearing loss across all frequency domains, even after adjusting for potential confounders. A nonlinear relationship was observed, with a threshold effect indicating a stronger association at lower BRI levels. Machine learning models confirmed the predictive value of BRI, with shapley additive explanations analysis highlighting its importance relative to other metabolic and environmental factors. BRI has been demonstrated to be a significant predictor of hearing loss, thus suggesting that central obesity may contribute to auditory dysfunction. These findings emphasize the necessity for obesity management to be incorporated into hearing loss prevention strategies, and they underscore BRI as a potential screening tool for identifying individuals at risk of auditory impairment.