Article record

听力干预对基于血液的神经炎症和神经退行性变生物标志物的影响：ACHIEVE随机对照试验的二次分析

Effects of hearing intervention on blood-based biomarkers of neuroinflammation and neurodegeneration: a secondary analysis of the ACHIEVE randomised controlled trial.

临床研究耳科IF 11.8Q1

文献信息

PMID	42733779
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	James Russell Pike 查看其他 22 位作者 Alison R Huang；Nicholas Reed；Michelle L Arnold；Theresa H Chisolm；David Couper；Jennifer A Deal；Sarah Faucette；Adele M Goman；Rebecca F Gottesman；Timothy M Hughes；David Knopman；Christine Mitchell；Thomas H Mosley；Priya Palta；James S Pankow；Victoria A Sanchez；Elizabeth Selvin；Kevin J Sullivan；Bharat Thyagarajan；Lynne E Wagenknecht；Frank R Lin；Josef Coresh
作者单位	Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA. 查看其他 16 条单位信息 Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.；Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.；Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.；Department of Communication Sciences & Disorders, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL, USA.；Department of Otolaryngology-Head & Neck Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.；Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.；Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.；The MIND Center, University of Mississippi Medical Center, Jackson, MS, USA.；School of Psychology, University of Leeds, UK.；National Institute of Neurological Disorders & Stroke Intramural Research Program, National Institutes of Health, Bethesda, MD, USA.；Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.；Department of Neurology, Mayo Clinic, Rochester, MN, USA.；Department of Neurology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.；Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.；Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.；Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
期刊	EClinicalMedicine
SCI 分区	Q1
IF	11.8
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

背景： 研究表明，老年人的听力损失与神经炎症和神经退行性变升高有关，而这两者都是痴呆的危险因素。在衰老与认知健康评估（ACHIEVE）随机对照试验（ClinicalTrials.gov标识符：NCT03243422）的二次分析中，我们检验了听力干预是否减缓了基于血液的神经炎症生物标志物（胶质纤维酸性蛋白[GFAP]）和神经退行性变生物标志物（神经丝轻链[NfL]）的3年变化。
方法： ACHIEVE是一项在美国于2018年1月4日至2022年11月30日期间进行的临床试验，旨在测试听力干预（听力学咨询、提供助听器）与健康教育对照（慢性病预防咨询）对无显著认知障碍且患有未治疗听力损失的老年人3年认知下降的影响。在从社区动脉粥样硬化风险队列招募的ACHIEVE参与者中，于基线时和三年后采集血浆。协变量调整的线性混合效应模型估计了意向性治疗对GFAP和NfL逆正态转换值3年变化的效应。
结果： 分析样本中的参与者（n = 164）平均（SD）年龄为78.1（2.9）岁，64.0%为女性，73.2%为白人。在三年内，听力干预与GFAP上升较慢相关（干预组：-0.026；95% CI：-0.144，0.093，对照组：0.149；95% CI：0.039，0.260；差异：-0.175；95% CI：-0.322，-0.028；p-差异：0.019）和NfL上升较慢相关（干预组：0.171；95% CI：0.022，0.319，对照组：0.330；95% CI：0.185，0.475，差异：-0.159；95% CI：-0.348，0.029；p-差异：0.098）。
解释： 随机分配至听力干预与基于血液的神经炎症生物标志物三年上升较慢相关。在神经退行性变方面观察到类似的估计值，尽管该效应未达到统计学显著性。研究结果表明，听力干预可能降低与大脑健康和痴呆进展相关的非特异性基于血液的生物标志物的变化率。
资助： 美国国立卫生研究院。

英文摘要

BACKGROUND: Research suggests that hearing loss in older adults is associated with elevated neuroinflammation and neurodegeneration, both of which are risk factors for dementia. In a secondary analysis of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) randomised controlled trial (ClinicalTrials.gov identifier: NCT03243422), we examined if hearing intervention slowed 3-year change in blood-based biomarkers of neuroinflammation (glial fibrillary acidic protein [GFAP]) and neurodegeneration (neurofilament light chain [NfL]).
METHODS: ACHIEVE, a clinical trial in the United States conducted between January 4, 2018 and November 30, 2022, tested the effects of hearing intervention (audiological counselling, provision of hearing aids) versus health education control (counselling on chronic disease prevention) on 3-year cognitive decline among older adults without substantial cognitive impairment and with untreated hearing loss. Plasma was collected at baseline and three years later among ACHIEVE participants recruited from the Atherosclerosis Risk in Communities cohort. Covariate-adjusted linear mixed effects models estimated intention-to-treat effects on 3-year change in inverse-normal transformed values of GFAP and NfL.
FINDINGS: Participants in the analytic sample (n = 164) were mean (SD) age 78.1 (2.9) years, 64.0% female, and 73.2% White. Over three years, hearing intervention was associated with a slower rise in GFAP (intervention: -0.026; 95% CI: -0.144, 0.093, control: 0.149; 95% CI: 0.039, 0.260; difference: -0.175; 95% CI: -0.322, -0.028; p-difference: 0.019) and NfL (intervention: 0.171; 95% CI: 0.022, 0.319, control: 0.330; 95 %CI: 0.185, 0.475, difference: -0.159; 95 %CI: -0.348, 0.029; p-difference: 0.098).
INTERPRETATION: Randomisation to hearing intervention was associated with a slower three-year rise in a blood-based biomarker of neuroinflammation. Comparable estimates were observed for neurodegeneration, although the effect was not statistically significant. Findings suggest that hearing intervention may reduce the rate of change in non-specific blood-based biomarkers associated with brain health and dementia progression.
FUNDING: US National Institutes of Health.