[Gender differences in comorbidity characteristics among patients with sudden sensorineural hearing loss]

Objective: To investigate gender differences in comorbidity profiles among patients with sudden sensorineural hearing loss (SSNHL). Methods: The study was a cross-sectional analysis based on patients with SSNHL enrolled from the Chinese Refractory Inner Ear Disease Cohort, which covered 29 provinces (autonomous regions/municipalities) in China. Patients were consecutively included between July 2024 and November 2025. Demographic characteristics, lifestyle factors, systemic comorbidities, and inner ear comorbidities were collected using a standardized questionnaire. Baseline characteristics and comorbidity distributions were compared between males and females. Multivariable logistic regression models were applied to evaluate the associations between gender and inner ear comorbidities. Results: A total of 2 844 patients aged 48.7 (37.0, 60.3) years were included, with 1 217 males and 1 627 females. Male patients had significantly higher proportions of smoking, alcohol consumption, and noise exposure, whereas a history of motion sickness was more common in females (P<0.001). Regarding systemic comorbidities, female patients showed higher prevalences of migraine, thyroid dysfunction, cervical spondylosis, and autoimmune diseases, while male patients had higher prevalences of hypertension, coronary heart disease, diabetes mellitus, hyperlipidemia, and cerebrovascular disease (all P<0.05). Multivariable logistic regression analysis demonstrated that, compared with females, males had increased risks of hypertension (OR=2.28, 95%CI: 1.62-3.22), coronary heart disease (OR=3.10, 95%CI: 1.53-6.29), cerebrovascular disease (OR=2.26, 95%CI: 1.15-4.41), and sinusitis (OR=1.59, 95%CI: 1.13-2.22), but lower risks of migraine (OR=0.18, 95%CI: 0.10-0.32), thyroid disease (OR=0.20, 95%CI: 0.09-0.41), cervical spondylosis (OR=0.43, 95%CI: 0.30-0.60), and autoimmune disease (OR=0.34, 95%CI: 0.11-0.90). Regarding inner ear comorbidities, aural fullness (77.7%, 2 189/2 816) and tinnitus (87.1%, 2 454/2 816) were highly prevalent, with no significant differences between males and females (all P>0.05). Age-stratified analysis showed that among patients older than 45 years, males had a significantly lower risk of tinnitus compared with females (OR=0.58, 95%CI: 0.36-0.95). Conclusions: Gender differences exist in the comorbidity spectrum of patients with SSNHL. Male patients are more likely to be accompanied by hypertension, coronary heart disease, cerebrovascular disease, and sinusitis, whereas female patients are more prone to migraine, thyroid disease, cervical spondylosis, and autoimmune diseases. Among patients older than 45 years, males have a lower risk of tinnitus than females.