铜摄入量与听力损失的关联：一项横断面研究

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中文摘要

目前，关于铜摄入量与听力损失（HL）之间关系的证据不足；因此，需要进一步研究。本研究旨在探讨美国成年人中铜摄入量与HL之间的潜在关联。我们使用2015-2016年全国健康与营养调查（NHANES）中2777名参与者的数据，进行了一项回顾性横断面研究。收集了所有参与者的铜摄入量和HL测量数据。采用多变量逻辑回归、限制性立方样条和亚组分析来评估研究目标。在完全调整的模型3中，连续膳食铜摄入量与言语频率听力损失（SFHL，OR=0.71，95%CI：0.55-0.91，p=0.008）和高频听力损失（HFHL，OR=0.74，95%CI：0.60-0.91，p=0.004）呈负相关。相对于Q1，Q3和Q4与SFHL呈显著负相关；HFHL在Q2和Q4而非Q3中发现显著负相关。两种结局在四分位数间均存在显著线性趋势（表2）。亚组分析表明SFHL存在显著的性别交互作用（p=0.023）。铜摄入量与两种听力损失之间的显著负相关仅在女性中观察到。按年龄、慢性疾病和噪声暴露分层的亚组中发现了异质性关联，大多数交互项不显著（表3，图3）。限制性立方样条模型显示，膳食铜摄入量与SFHL（非线性p=0.328）或HFHL（非线性p=0.616）之间无统计学显著的非线性关联（图2）。我们的研究结果表明，美国成年人中膳食铜摄入量与听力损失之间存在负线性关联，且这种关联受性别影响，仅在女性中具有统计学显著性。需要进一步研究以探索潜在机制。

英文摘要

Currently, evidence for the relationship between copper intake and hearing loss (HL) is insufficient; therefore, further research is needed. This study aimed to investigate the potential association between copper intake and HL in adults in the United States. We conducted a retrospective cross-sectional study using data from 2777 participants of the 2015-2016 National Health and Nutrition Examination Survey (NHANES). Measurements of copper intake and HL were collected for all participants. Multivariate logistic regression, restricted cubic spline, and subgroup analyses were used to assess the research objectives. In fully adjusted Model 3, continuous dietary copper intake was inversely associated with speech-frequency hearing loss (SFHL, OR = 0.71, 95%CI:0.55-0.91, p = 0.008) and high-frequency hearing loss (HFHL, OR = 0.74, 95%CI:0.60-0.91, p = 0.004). Relative to Q1, Q3 and Q4 showed significant inverse associations with SFHL; significant inverse associations with HFHL were found in Q2 and Q4 rather than Q3. Significant linear trends across quartiles existed for both outcomes (Table 2). Subgroup analyses indicated significant sex interaction for SFHL (p = 0.023). Significant inverse associations between copper intake and two types of hearing loss were only observed in females. Heterogeneous associations were found across subgroups stratified by age, chronic disease and noise exposure, with most interaction terms non-significant (Table 3, Fig. 3). Restricted cubic spline models demonstrated no statistically significant nonlinear association between dietary copper intake and either SFHL (p for non-linearity = 0.328) or HFHL (p for non-linearity = 0.616) (Fig. 2). Our findings suggested an inverse linear association between dietary copper intake and hearing loss among US adults, and this association was modified by sex, being statistically significant only in females. Further research is needed to explore the underlying mechanisms.