Hyperuricemia Linked to Hearing Impairment in Women, Elderly Patients

Hyperuricemia was independently linked to hearing impairment, particularly in women and patients aged ≥60 years, according to a study published in Medicina.¹

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Hearing loss, which currently affects 430 million people and is estimated to increase to over 700 million by 2050, has a significant impact on social interaction and can reduce overall quality of life. Previous research has indicated age-related hearing loss is linked to cognitive impairment, cognitive decline, and dementia. Risk factors for the development of hearing impairment include age, noise exposure, and male sex.² Hyperuricemia, often associated with gout, is also associated with a number of comorbidities including hypertension, obesity, stroke, chronic kidney disease, and cardiovascular issues.³

“Recently, a large cohort study reported that gout is significantly associated with a 44% higher risk of new hearing loss in adults aged ≥65 years,” wrote a team of Korean investigators. “However, United States National Health and Nutrition Examination Survey data have shown that higher uric acid levels are associated with better hearing sensitivity. Thus, results about the association between uric acid and hearing impairment are inadequate and controversial.”

Audiometric and laboratory test data from the 2019 – 2020 Korean National Health and Nutrition Examination Survey were evaluated to determine hearing impairment, defined as a pure-tone average (.5, 1, 2, 4 kHz) threshold level of ≥41 decibels. Hyperuricemia was defined as >7 mg/dL for male patients and >6 mg/dL for female patients.

A total of 4857 patients aged ≥40 years, with a mean age of 56.8 years, were included in the analysis. The weighted prevalence was 12.1% for hyperuricemia and 2.5% for gout. The incidence of hearing impairment was 13.4%.

According to the univariable analysis, although gout was not associated with hearing loss (odds ratio [OR]: .83, P = .554), hyperuricemia was significantly linked to impairment (OR: 1.55, P = .002). In the multivariable analysis, in addition to hyperuricemia (OR: 1.41, 95% confidence interval [CI]: 1.03 – 1.92, P = .030), hearing impairment was associated with age (OR: 1.12, 95% CI: 1.10 – 1.14, P <.001), female sex (OR: .43, 95% CI: .34 – 0.64, P <.001), occupational noise exposure (OR: 1.67, 95% CI: 1.25 – 2.22, P = .001), and university-level education (OR: .43, 95% CI: .30 – .63, P = .001).

According to subgroup analysis, hyperuricemia was linked to hearing impairment in female patients (OR: 1.59, 95% CI: 1.02 – 2.48, P = .041) and elderly patients aged ≥60 years = (OR: 1.45, 95% CI: 1.05 – 1.99, P = .023). Female participants with hyperuricemia were older and the weighted prevalence rates of diabetes and hypertension were higher compared with patients with normal uric acid levels. Gout was not significantly associated with hearing loss in any subgroup analysis.

Investigators noted the study was unable to collect data on uric acid-lowering agents or diuretics which may have impacted the serum uric acid levels. Further, a gout diagnosis was dependent on information supplied by participants during the interview and specific criteria was not applied for the definition of gout. An additional limitation was only conducting audiometric measurements for participants aged ≥40 years. Therefore, findings should only be interpreted for this patient population.

“Despite all these limitations, the strength of this study lies in the fact that we analyzed the relationship between uric acid and hearing impairment in a nationwide representative sample of the general adult population,” investigators concluded. “Further investigations are required to clarify the relationship between serum uric acid levels and hearing impairment.”

References

1. ^{Jeong H, Chang YS, Jeon CH. Association between Hyperuricemia and Hearing Impairment: Results from the Korean National Health and Nutrition Examination Survey. Medicina (Kaunas). 2023;59(7):1273. Published 2023 Jul 9. doi:10.3390/medicina59071273}
2. ^{Agrawal, Y.; Platz, E.A.; Niparko, J.K. Prevalence of hearing loss and differences by demographic characteristics among US adults: Data from the National Health and Nutrition Examination Survey, 1999–2004. Arch. Intern. Med. 2008, 168, 1522–1530}
3. ^{Zhu, Y.; Pandya, B.J.; Choi, H.K. Comorbidities of Gout and Hyperuricemia in the US General Population: NHANES 2007–2008. Am. J. Med. 2012, 125, 679–687.e1}