Association between serum potassium levels and hearing loss: Evidence from a cross-sectional study based on NHANES

Hearing loss is a global public health issue, and potassium imbalance may affect inner ear function, thereby impacting hearing. Currently, research on the association between serum potassium levels and hearing loss remains limited. This study utilized National Health and Nutrition Examination Survey data to investigate the relationship between serum potassium levels and hearing loss, offering a theoretical basis for the prevention of hearing loss. National Health and Nutrition Examination Survey data were analyzed using multivariable logistic regression models to examine the association between serum potassium levels and hearing loss. To explore potential nonlinear relationships, restricted cubic spline analysis was performed. Subgroup analyses and interaction tests were also carried out to investigate how this association varied across different populations. The study included 10,009 eligible participants, among whom 2952 (29.5%) were diagnosed with speech-frequency hearing loss (SFHL), 2216 (22.1%) with low-frequency hearing loss (LFHL), and 4688 (46.8%) with high-frequency hearing loss (HFHL). The results indicated a significant positive association between serum potassium levels and SFHL, LFHL, and HFHL (SFHL: odds ratio [OR] = 1.49, 95% confidence interval [CI]: 1.15-1.94, P = .003; LFHL: OR = 1.45, 95% CI: 1.16-1.82, P = .002; HFHL: OR = 1.57, 95% CI: 1.29-1.92, P < .001). Trend tests showed P < .05. Restricted cubic spline analysis demonstrated a linear relationship between serum potassium levels and SFHL, LFHL, and HFHL. Interaction tests suggested that factors such as sex, race/ethnicity, and diabetes status significantly modified the association between serum potassium levels and hearing loss. Elevated serum potassium levels are significantly positively associated with the prevalence of hearing loss. These findings provide new insights into the potential role of serum potassium in auditory health and may offer strategies for early prevention and metabolic intervention in hearing loss.