中年韩国女性（40至64岁）的久坐时间与当前耳鸣：基于KNHANES 2014-2018的横断面分析

文献信息

中文摘要

背景/目的： 耳鸣随年龄增长而更为常见，年龄相关性听力损失在晚年病例中所占比例不断增加，而可改变的行为因素在中年可能相对贡献更大。将久坐时间——一个与缺乏身体活动不同的构念——与耳鸣联系起来的基于人群的证据有限，且尚未考虑心理和睡眠相关因素。
方法： 我们分析了韩国国家健康与营养调查（KNHANES）2014-2018中40-64岁的韩国女性，这是一项全国性复杂抽样调查（N = 7239；当前耳鸣患病率21.9%）。自我报告的每日久坐时间按调查加权四分位数分类（切点为5、7和10小时/天）。调查加权的改良泊松回归估计了调整后的患病率比（aPRs），调整了人口学、社会经济、行为、有氧活动和听觉因素；进一步模型加入了感知压力、抑郁症状、医生诊断的抑郁症、睡眠时长、绝经状态和非职业性噪声。
结果： 耳鸣患病率随四分位数升高（加权19.7%、21.6%、23.2%和24.9%；模型标准化19.4%、21.9%、23.5%和24.9%）。相对于最低四分位数，aPRs分别为1.13（95%置信区间0.98-1.31）、1.21（1.07-1.36）和1.29（1.11-1.49；p = 0.0007），每四分位数的趋势为1.09（p = 0.0001）。在调整心理健康和睡眠后，估计值为1.26（1.09-1.46），完全调整时为1.27（1.10-1.47）。在男性中也观察到类似关联（1.22，1.03-1.45；久坐与性别交互作用p = 0.93）；在65岁及以上女性中则不存在（0.86，0.74-1.01）。
结论： 较长的久坐时间与当前耳鸣患病率轻度升高相关，且不能由所测量的协变量解释。该设计为横断面，绝对差异较小（5.6个百分点），且不能排除反向因果；需要前瞻性验证。

英文摘要

Background/Objectives: Tinnitus becomes more common with age, and age-related hearing loss accounts for an increasing share of cases in later life, whereas modifiable behavioural factors may contribute relatively more in midlife. Population-based evidence linking sitting time-a construct distinct from physical inactivity-to tinnitus is limited and has not accounted for psychological and sleep-related correlates. Methods: We analysed Korean women aged 40-64 years in the Korea National Health and Nutrition Examination Survey (KNHANES) 2014-2018, a nationwide complex-sample survey (N = 7239; current tinnitus prevalence 21.9%). Self-reported daily sedentary time was categorised into survey-weighted quartiles (cut-points 5, 7, and 10 h/day). Survey-weighted modified-Poisson regression estimated adjusted prevalence ratios (aPRs), adjusting for demographic, socioeconomic, behavioural, aerobic-activity, and auditory factors; further models added perceived stress, depressive symptoms, physician-diagnosed depression, sleep duration, menopausal status, and non-occupational noise. Results: Tinnitus prevalence rose across quartiles (weighted 19.7%, 21.6%, 23.2%, and 24.9%; model-standardised 19.4%, 21.9%, 23.5%, and 24.9%). Relative to the lowest quartile, aPRs were 1.13 (95% confidence interval 0.98-1.31), 1.21 (1.07-1.36), and 1.29 (1.11-1.49; p = 0.0007), with a trend of 1.09 per quartile (p = 0.0001). The estimate was 1.26 (1.09-1.46) after mental-health and sleep adjustment, and 1.27 (1.10-1.47) when fully adjusted. A similar association was seen in men (1.22, 1.03-1.45; sedentary-by-sex interaction p = 0.93); in women aged 65 years and over it was absent (0.86, 0.74-1.01). Conclusions: Longer sedentary time was associated with a modestly higher prevalence of current tinnitus, not accounted for by the measured covariates. The design is cross-sectional, the absolute difference was small (5.6 percentage points), and reverse causation cannot be excluded; prospective confirmation is required.