Systemic Inflammatory Indices and Hearing Loss in U.S. Adults Aged 40-85 Years: A Serial Cross-Sectional Study 1999-2020

Systemic inflammatory indices, linked to immunosenescence-related diseases, have not been thoroughly studied in hearing loss. This study aimed to determine whether systemic inflammatory indices are associated with hearing loss in midlife and later life.

This serial cross-sectional, community-based investigation was conducted within the National Health and Nutrition Examination Survey 1999-2020 in United States. Hearing loss was defined as a pure-tone average of ≥ 20 decibel hearing level at 0.5, 1, 2, and 4 kHz in the better ear. Six systemic inflammatory indices included systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR). Prevalence ratios (PRs) with 95% confidence intervals (CIs) derived from modified Poisson regression models (with adjustment for potential confounding factors) represented the associations between each systemic inflammatory index and hearing loss.

A total of 7920 adults aged 40-85 years were included. The mean (standard deviation) age was 58.6 (11.8) years, 4310 (54.4%) were women, and 2262 (28.6%) had hearing loss. After adjustment, hearing loss was associated with SIRI (PR 1.14, 95% CI, 1.08-1.20), SII (PR 1.07, 95% CI, 1.02-1.13), PIV (PR 1.11, 95% CI, 1.06-1.16), NLR (PR 1.10 95% CI, 1.04-1.17), and LMR (PR 0.87, 95% CI, 0.81-0.94).

This study provides insights into the associations between systemic inflammatory indices and hearing loss, offering potential implications for risk stratification. While these indices are potential indicators for chronic inflammation in adults with hearing loss, further external validations are needed.