Article record

听力损失、助听器使用与死亡风险：澳大利亚、冰岛和美国基于人群研究的个体参与者数据荟萃分析及挪威重复研究

Hearing loss, hearing-aid use, and mortality risk: individual participant data meta-analysis of population-based studies from Australia, Iceland, and the USA and a replication study from Norway.

综述 Meta耳科IF 20.7Q1

文献信息

PMID	42869063
原文	在 PubMed 查看原文 ↗
发表日期	2027
作者	Chuan-Ming Li 查看其他 7 位作者 Howard J Hoffman；Bo Engdahl；Bamini Gopinath；Catherine M McMahon；Christa L Themann；Vilmundur Gudnason；Adrian C Davis
作者单位	Department of Epidemiology, Statistics, and Population Sciences, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA. 查看其他 7 条单位信息 Department of Epidemiology, Statistics, and Population Sciences, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA. Electronic address: hoffmanh@nidcd.nih.gov.；Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway.；Macquarie University Hearing Research Centre, School of Health Sciences and Nursing, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.；Australian Hearing Hub, Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.；Noise and Bioacoustics Team, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA.；Icelandic Heart Association Research Institute and University of Iceland, Kópavogur, Iceland.；Departments of Audiology and Ear, Nose and Throat, Imperial College London, London, UK; Department of Population Health, London School of Economics, London, UK.
期刊	The lancet. Healthy longevity
SCI 分区	Q1
IF	20.7
研究类型	综述 Meta · 临床
所属专科	耳科

中文摘要

背景： 听力损失与较差的健康状况、抑郁、认知下降相关，并且可能与死亡风险增加相关。助听器是否能改善这种关联尚不十分清楚。我们进行了一项荟萃分析并辅以重复研究，以检验听力损失、当前助听器使用与死亡率之间的关联。
方法： 使用个体参与者数据（IPD）荟萃分析，对三项合并的基于人群的研究中的听力阈值数据、全因死亡率以及心血管疾病（CVD）相关死亡率（各数据集可获取时）进行分析：蓝山听力研究（BMHS，澳大利亚，1997-2007）、年龄、基因/环境易感性-雷克雅未克研究（AGES-RS，冰岛，2002-06）以及美国国家健康与营养调查（NHANES，美国，1999-2006）。选择北特伦德拉格听力损失研究（NTHLS，挪威，1996-98）进行重复验证。对BMHS（n=2689）、AGES-RS（n=5171）和NHANES（n=5992）组成的联合联盟数据集进行IPD荟萃分析，使用Cox回归估计风险比和95%置信区间，并调整年龄、性别、教育、BMI、吸烟、心绞痛或心脏病发作、糖尿病、高血压、卒中以及噪声暴露史；NTHLS数据以类似方式分析。听力损失由全球疾病负担听力损失专家组和WHO认可的较好耳纯音平均类别定义。
结果： IPD荟萃分析纳入13 851名参与者，平均年龄61.8岁（SD 18.5；男性6228人[45.0%]，女性7622人[55.0%]）。轻度（1.19 [95% CI 1.10-1.29]）、中度（1.55 [1.42-1.70]）和中重度或更严重（1.56 [1.38-1.76]）听力损失与全因死亡风险增加相关。轻度（1.18 [95% CI 1.02-1.37]）、中度（1.43 [1.22-1.67]）和中重度或更严重（1.30 [1.05-1.60]）听力损失也与CVD相关死亡风险增加相关。当前使用助听器与全因死亡风险降低相关[0.91（95% CI 0.83-0.99）]，并与CVD相关死亡风险降低相关[0.85（0.73-0.99）]。NTHLS重复研究纳入50 277名成人（男性23 532人[46.8%]，女性26 745人[53.2%]），证实了这些发现。
解释： IPD荟萃分析和挪威NTHLS证实，听力损失严重程度增加与更高的死亡风险显著相关。使用助听器与死亡风险降低相关。助听器使用、其他形式的听力康复与成人预期寿命延长之间的潜在联系是未来研究的重要领域。
资助： 麦考瑞大学；美国国立卫生研究院国家耳聋和其他沟通障碍研究所；冰岛心脏协会（Hjartavernd）；美国疾病控制与预防中心国家职业安全与健康研究所；以及挪威公共卫生研究所。

英文摘要

BACKGROUND: Hearing loss is associated with poorer health, depression, cognitive decline, and perhaps, with increased mortality risk. Whether hearing aids ameliorate this association is not well understood. We conducted a meta-analysis with a replication study to examine associations between hearing loss, current use of hearing aids, and mortality.
METHODS: Hearing threshold data, all-cause mortality, and cardiovascular disease (CVD)-related mortality (available across datasets) were analysed using individual participant data (IPD) meta-analysis of three combined population-based studies: Blue Mountains Hearing Study (BMHS, Australia, 1997-2007), Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-RS, Iceland, 2002-06), and National Health and Nutrition Examination Survey (NHANES, USA, 1999-2006). The Nord-Trøndelag Hearing Loss Study (NTHLS, Norway, 1996-98) was chosen for replication. An IPD meta-analysis of the combined consortium datasets for BMHS (n=2689), AGES-RS (n=5171), and NHANES (n=5992) was performed using Cox regression to estimate hazard ratios and 95% CIs, after adjusting for age, sex, education, BMI, smoking, angina or heart attack, diabetes, hypertension, stroke, and noise-exposure history; NTHLS data were analysed similarly. Hearing loss was defined by better ear pure-tone average categories endorsed by the Global Burden of Disease Hearing Loss Expert Group and WHO.
FINDINGS: The IPD meta-analysis included 13 851 participants, with a mean age of 61·8 (SD 18·5; men 6228 [45·0%], women 7622 [55·0%]). Mild (1·19 [95% CI 1·10-1·29]), moderate (1·55 [1·42-1·70]), and moderately severe or worse (1·56 [1·38-1·76]) hearing loss were associated with increasing all-cause mortality risk. Mild (1·18 [95% CI 1·02-1·37]), moderate (1·43 [1·22-1·67]), and moderately severe or worse (1·30 [1·05-1·60]) hearing loss were also associated with increased CVD-related mortality risk. Current use of hearing aids was associated with reduced all-cause mortality risk [0·91 (95% CI 0·83-0·99)] and reduced CVD-related mortality [0·85 (0·73-0·99)]. The NTHLS replication study of 50 277 adults (men 23 532 [46·8%], women 26 745 [53·2%]) corroborated these findings.
INTERPRETATION: The IPD meta-analysis and Norwegian NTHLS confirmed that increasing severity of hearing loss is significantly associated with higher mortality risk. Use of hearing aids was associated with reduced mortality risk. The potential link between hearing-aid use, other forms of hearing rehabilitation, and increased life expectancy in adults is an important area for future research investigation.
FUNDING: Macquarie University; National Institute on Deafness and Other Communication Disorders, National Institutes of Health; Icelandic Heart Association (Hjartavernd); National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; and Norwegian Institute of Public Health.