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Hearing loss is associated with increased risk of incident stroke but not coronary heart disease among middle-aged and older Chinese adults: the Dongfeng-Tongji cohort study

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Abstract

Hearing loss has been associated with increased risk of cardiovascular disease (CVD) prevalence in cross-sectional studies. However, little is known about the prospective association between hearing loss and CVD incidence. We aimed to examine the associations of hearing loss with risk of incident CVD, coronary heart disease (CHD), and stroke in a Chinese population. We included 13,880 individuals aged 63.3 years from the Dongfeng-Tongji cohort study (2013–2018). Hearing loss was categorized into normal, mild, moderate, severe, or greater by the pure-tone average of thresholds at speech and high frequency in both ears. Cox proportional hazard models and linear regression models were used for multivariate longitudinal analyses. After multivariate adjustments, we observed suggestive dose–response associations of increased high-frequency hearing loss with elevated risk of CVD and stroke incidence. Compared with normal hearing loss at high frequency, those with moderate and severe or greater hearing loss had a 4% (95% CI: 0.92, 1.18) or 13% (95% CI: 0.98, 1.30) higher risk of CVD and 52% (95% CI: 1.06, 2.17) or 51% (95% CI: 1.03, 2.20) higher risk of stroke, while the associations were almost consistent across most subgroups. No significant associations were observed for CHD and high-frequency hearing loss, as well as CVD and speech-frequency hearing loss. In addition, higher high-frequency hearing loss was related to unfavorably altered lipid profiles and fasting glucose. Our data suggested that increased hearing loss might increase the risk of incident CVD and stroke among middle-aged and older Chinese, which was partially explained by altered CVD-related biomarkers.

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Data Availability

No additional data available.

All participants gave written informed content on document approved by the Ethics and Human Subject Committee of Tongji Medical College and Dongfeng General Hospital.

Abbreviations

BMI:

Body mass index

CHD:

Coronary heart disease

CI:

Confidence interval

CVD:

Cardiovascular disease

DMC:

Dongfeng Motor Corporation

HDL-c:

High-density lipoprotein cholesterol

HR:

Hazard ratio

LDL-c:

Low-density lipoprotein cholesterol

MET-h:

Metabolic equivalent hours

MRI:

Magnetic resonance imaging

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Acknowledgements

We thank the participants and staff of the Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Dongfeng Central Hospital, and the Medical Insurance Center of DMC for their valuable contributions to scientific research.

Funding

This work was supported by the National Natural Science Foundation of China (81973128) and Fundamental Research Funds for the Central Universities, HUST (2020kfyXJJS058). The funders had no roles in the study design, implementation, analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Liangle Yang and Qin Fang contributed equally to this work.

Authors and Affiliations

  1. Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, and State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Liangle Yang, Lue Zhou, Hao Wang, Meian He & Xiaomin Zhang

  2. Department of Medical Affairs, Zhuhai People’s Hospital (Zhuhai Hospital Affiliated With Jinan University), Zhuhai, 519000, Guangdong Province, China

    Qin Fang

  3. Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China

    Handong Yang

  4. Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Zhichao Wang & Weijia Kong

Authors
  1. Liangle Yang
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  2. Qin Fang
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  3. Lue Zhou
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Contributions

Prof. Zhang and Prof. Kong had full access to all data and took responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Xiaomin Zhang and Weijia Kong.

Acquisition, analysis, or interpretation of the data: All authors.

Drafting of the manuscript: Liangle Yang and Qin Fang.

Critical revision of the manuscript for important intellectual contents: All authors.

Statistical analysis: Liangle Yang and Qin Fang.

Obtained Funding: Xiaomin Zhang and Liangle Yang.

Administrative, technical, or material support: Lue Zhou, Hao Wang, Handong Yang, and Zhichao Wang.

Supervision: Meian He.

Corresponding authors

Correspondence to Weijia Kong or Xiaomin Zhang.

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Yang, L., Fang, Q., Zhou, L. et al. Hearing loss is associated with increased risk of incident stroke but not coronary heart disease among middle-aged and older Chinese adults: the Dongfeng-Tongji cohort study. Environ Sci Pollut Res 29, 21198–21209 (2022). https://doi.org/10.1007/s11356-021-17324-6

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