Elevated ApoB/ApoA ratio is associated with increased risk of sudden sensorineural hearing loss

To investigate the association between the apolipoprotein B to apolipoprotein A (ApoB/ApoA) ratio and sudden sensorineural hearing loss (SSNHL) risk in Nantong, China.

This cross-sectional study included 1211 participants (674 with normal hearing, 537 with SSNHL). Baseline demographics, comorbidities, and biochemical indicators were compared. Multivariable logistic regression evaluated the independent association between the ApoB/ApoA ratio and SSNHL risk. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were applied for sensitivity analysis. Stratified and dose-response analyses were also conducted.

The groups differed significantly in age, sex, hypertension, BMI, and various metabolic markers (all P < 0.05). In the fully adjusted model, an elevated ApoB/ApoA ratio was significantly associated with increased SSNHL risk (OR = 9.34, 95% CI: 3.93-22.21). This positive association remained robust after PSM (OR = 8.79, 95% CI: 3.26-23.66). IPTW analysis showed the high-ratio group (0.78-1.34) had a higher SSNHL risk than the low-ratio group (0.13-0.58) (OR = 2.28, 95% CI: 1.79-2.90). Dose-response analysis indicated a significant linear positive correlation between the ratio and SSNHL prevalence, both before and after PSM. Stratified analyses demonstrated this association remained consistent across age, sex, hypertension, and diabetes subgroups (all P for interaction > 0.05).

A high ApoB/ApoA ratio has a significant linear positive association with increased SSNHL risk. It serves as an independent clinical biomarker for SSNHL risk assessment, providing a basis for metabolic management.