Occupational Noise, Smoking, and a High Body Mass Index are Risk Factors for Age-related Hearing Impairment and Moderate Alcohol Consumption is Protective: A European Population-based Multicenter Study

A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data (pure-tone average [PTA]) were collected and the participants filled out a questionnaire on environmental risk factors and medical history. People with a history of disease that could affect hearing were excluded. PTAs were adjusted for age and sex and tested for association with exposure to risk factors. Noise exposure was associated with a significant loss of hearing at high sound frequencies (>1 kHz). Smoking significantly increased high-frequency hearing loss, and the effect was dose-dependent. The effect of smoking remained significant when accounting for cardiovascular disease events. Taller people had better hearing on average with a more pronounced effect at low sound frequencies (<2 kHz). A high body mass index (BMI) correlated with hearing loss across the frequency range tested. Moderate alcohol consumption was inversely correlated with hearing loss. Significant associations were found in the high as well as in the low frequencies. The results suggest that a healthy lifestyle can protect against age-related hearing impairment

Hearing among older adults–an epidemiological study

Abstract Age-related hearing impairment is the most common type of hearing impairment among adults. Adult-onset hearing impairment is one of the leading causes of disease burden worldwide and it is associated with social isolation and depression. As the proportion of older people is increasing in Western countries, the socioeconomic importance of adult hearing impairment will increase notably. The aim of the present contribution was to study the epidemiological aspects of hearing and related factors among older adults. The prevalence of hearing impairment, defined either by audiometry or by a self-report, and the differences between these two were analyzed. Tinnitus and hyperacusis were also studied. Furthermore, the prevalence of ear diseases, otological risk factors, and noise exposure and their association with hearing thresholds were analyzed. In addition, audiogram configurations and certain subject-related factors and their relation to hearing were assessed. The subjects were randomly sampled from the population register and they responded to an extensive questionnaire. Otological status was examined and pure tone audiometry was conducted. Data on 850 subjects aged 54–66 years were analyzed. Hearing impairment was found to be a highly common condition with a prevalence of 26.7% when defined by better ear and 42.2% when defined by worse ear. Men had worse hearing than women. High-frequency sloping audiogram configurations were common. Self-reported hearing difficulty and measured hearing impairment seem to be associated at high frequencies. At least one ear disease or otological risk factor for hearing impairment was found among 18.4% of the subjects and noise exposure among 46%, more often by men. Interestingly, noise exposure did not seem to associate with hearing levels among subjects screened for ear disease or otological risk factors. The results of the present study suggest that hearing impairment is a highly common condition among older adults and this should be taken into account when future hearing healthcare is planned. Furthermore, it seems that most of the subjects reporting hearing difficulty had no measured hearing impairment according to the criteria applied for eligibility for hearing aid fitting in Finland. Based on the results of the present study, the criteria for hearing impairment entitling persons for hearing aid fitting should be reconsidered.Tiivistelmä Ikäkuulo on yleisin aikuisten kuulovian aiheuttaja, ja aikuisiän kuulovika on merkittävä terveydellinen haittatekijä. Kehittyneiden maiden ikäjakauman painottuessa vanhempiin ikäluokkiin aikuisten kuulovioista tulee merkittävä sosioekonominen rasite yhteiskunnille. Tutkimuksen tavoitteena oli selvittää aikuisten kuulovikojen epidemiologiaa ja kuulovikoihin liittyviä tekijöitä. Myös kuulovian vallitsevuus määriteltynä kuulokäyrän tai tutkittavan oman ilmoituksen perusteella selvitettiin. Samoin tutkittiin muita kuulemiseen liittyviä ongelmia, kuten tinnitusta ja ääniyliherkkyyttä. Edelleen arvioitiin erilaisten kuuloon vaikuttavien tekijöiden, kuten korvasairauksien, muiden kuulovian riskitekijöiden ja melulle altistumisen, vallitsevuutta väestössä sekä niiden assosiaatiota kuulemiseen. Näiden lisäksi tutkittiin kuulokäyrien muotoja ja niiden yhteyttä tutkittavan ilmoittamaan kuulo-ongelmaan. Tutkittavat valittiin satunnaisesti väestörekisteristä. He täyttivät laajan kyselylomakkeen, heidän korvansa tutkittiin lääkärin vastaanotolla ja lisäksi heille tehtiin kuulotutkimukset. Tutkimukseen osallistui 850 55–66-vuotiasta henkilöä. Tutkimus osoitti, että kuulovika on tässä ikäryhmässä hyvin yleinen löydös ja miehillä yleisempi kuin naisilla. Tutkittavan ilmoittama kuulovika ennusti mitattujen kuulokynnysten heikkenemistä korkeilla taajuuksilla (4–8&#160;kHz). Samoin korkeille taajuuksille laskeva kuulokäyrän muoto oli yleisin. Erilaisia kuulovian riskitekijöitä raportoi 18.4&#160;% tutkittavista. Tämän lisäksi 46&#160;% kertoi merkittävästä altistumisesta melulle, miehet naisia useammin. Yllättäen melualtistumisella ei näyttänyt olevan yhteyttä kuulokynnyksiin siinä ryhmässä tutkittavia, joilla ei ollut korvaperäisiä riskitekijöitä kuulovialle. Tutkimustulokset osoittavat, että kuulovika on hyvin yleinen löydös tämän ikäisillä aikuisilla. Vanhenevat ikäluokat ovat merkittävä haaste kuulonhuollolle, ja tämä olisi otettava huomioon päätettäessä kuulonhuollon rahoituksesta. Useat niistä aikuisista, jotka kokivat kuulo-ongelmia, eivät kuulokäyrälöydöksensä mukaan täyttäneet Suomessa käytössä olevia kriteereitä kuulokojesovitukselle. Tämän tutkimuksen perusteella näyttääkin siltä, että kuntoutustarvetta arvioitaessa kuulovian kriteereitä tulisi kansallisesti tarkistaa ottamalla huomioon myös huonomman korvan kuulokynnykset sekä kuulon alenema korkeilla taajuuksilla

The impact of cardiovascular diseases on hearing deterioration:a 13-year follow-up study

Abstract Objective: To study the impact of cardiovascular diseases (CVDs) on hearing deterioration among ageing adults in a longitudinal setting. Furthermore, to describe the pure tone threshold changes at the 0.125–8 kHz frequency range over 13 years. Design: A population-based follow-up study. Study sample: A random sample of 850 adults, of whom 559 participated in the follow-up study. Otological examination, a structured interview, and pure tone audiometry were conducted. Multivariate regression models were used to estimate the effect of CVD (participants had at least one cardiovascular condition) on hearing deterioration of the better ear hearing level (BEHL), defined as a change in the pure-tone average (PTA) of the frequencies 0.5, 1, 2, and 4 kHz and separately at the lower (0.125, 0.25, and 0.5 kHz) and higher (4, 6, and 8 kHz) frequencies. Results: In the multivariable-adjusted analysis, the BEHL change at 13 years was 0.7 dB greater among participants with CVD (p = 0.3). The mean BEHL change during the 13-year follow-up was 12.0 dB (95% CI 11.4–12.6) among all participants. Conclusions: No significant association between CVD and hearing threshold changes was found

Prevalence and incidence of hearing impairment among adults:a 13-year follow-up study

Abstract Objective: The aim of this study was to investigate the prevalence and incidence of hearing impairment (HI) in a longitudinal setting among adults. Design: An unscreened, population-based epidemiological 13-year follow-up study. Study sample: 850 randomly sampled 54 to 66-year-old baseline participants, of whom 559 participated in the follow-up study at the age of 68 to 79 years. A questionnaire-based interview, an otological examination and pure-tone audiometry were performed. Results: The overall prevalence of HI was 70.3%, defined by better ear hearing level (BEHL)  ≥ 20 dB in the 0.5‐4 kHz frequency range. The prevalence was higher among men (78.6%) than among women (63.7%). The overall incidence rate for HI was 45.8 per 1000 person years and the 13-year cumulative incidence was 60.9%. The incidence was higher among men and older participants. Conclusion: HI is highly prevalent and incident among older adults in Northern Finland

Perioperative risk factors for one-year mortality in patients with free-flap reconstruction due to cancer of the head and neck

Abstract Purpose: Head and neck cancer requiring free-flap reconstruction is associated with relatively high mortality. We aimed to evaluate perioperative risk factors for 1-year mortality in this patient group. Methods: This is a single-center retrospective analysis of 204 patients operated during 2008 to 2018. Results: A total of 47 (23.0%) patients died within 1 year. In univariate analysis, there were no differences in the intraoperative course between 1-year survivors and nonsurvivors. Among the 1-year nonsurvivors, preoperative albumin level was lower (39 [36 to 43] vs 42 [39 to 44], P = 0.032) and the Sequential Organ Failure Assessment admission score was higher (4 [3 to 5] vs 3 [2 to 4], P = 0.003) than those of the 1-year survivors. Among the nonsurvivors, the preoperative and postoperative levels of leukocytes were higher (7.6 [6.7 to 9.5] vs 6.9 [5.5 to 8.4], P = 0.002; 11.4 [9.0 to 14.2] vs 8.7 [7.2 to 11.3], P &lt; 0.001). The highest odds ratios for 1-year mortality in multivariate analysis were American Society of Anesthesiologists A classification greater than 2 (3.9 CI 1.4 to 10.5), male gender (4.0 CI 1.5 to 11), and increase in leukocyte count (1.3 CI 1.1 to 1.5). Conclusions: One-year nonsurvivors had higher American Society of Anesthesiologists classification and were more often men. The postoperative inflammatory markers were higher in nonsurvivors, while the intraoperative course did not have a significant impact on the 1-year mortality

Hearing impairment is common among Saami adults in Northern Finland

Abstract The Saami are the only indigenous population in Europe and their traditional living area is northern Scandinavia. Hearing impairment (HI) among Saami has not been studied before. The objective was to investigate the presence and type of HI among Saami adults, aged 49–77 years (median age 61 years), living in northern Finland. In addition, the presence of self-reported hearing difficulties, difficulties to hear in background noise and tinnitus were studied. An epidemiological, cross-sectional study encompassing a structured interview, otological examination and audiometry was performed. Bilateral HI was present in 42.9% of men and 29.4% of women, when HI was defined as a pure tone average (PTA) of at least 20 dB hearing level (HL) or more at the frequencies of 0.5, 1, 2 and 4 kHz. In one or both ears (worse ear hearing level, WEHL0.5,1,2,4≥20 dB HL) HI was present in 61.8% of men and 42.2% of women. Sensorineural high frequency hearing impairment was found to be most common. Nearly half (46.9%) of the study subjects reported hearing problems and more than half (55.6%) reported difficulties in following conversation in background noise. Measured HI and subjective hearing difficulties are common among the Saami adults. The healthcare personnel working in this area should be aware of the hearing problems of the Saami population

Chromosome Xq23 is associated with lower atherogenic lipid concentrations and favorable cardiometabolic indices

Autosomal genetic analyses of blood lipids have yielded key insights for coronary heart disease (CHD). However, X chromosome genetic variation is understudied for blood lipids in large sample sizes. We now analyze genetic and blood lipid data in a high-coverage whole X chromosome sequencing study of 65,322 multi-ancestry participants and perform replication among 456,893 European participants. Common alleles on chromosome Xq23 are strongly associated with reduced total cholesterol, LDL cholesterol, and triglycerides (min P=8.5x10(-72)), with similar effects for males and females. Chromosome Xq23 lipid-lowering alleles are associated with reduced odds for CHD among 42,545 cases and 591,247 controls (P=1.7x10(-4)), and reduced odds for diabetes mellitus type 2 among 54,095 cases and 573,885 controls (P=1.4x10(-5)). Although we observe an association with increased BMI, waist-to-hip ratio adjusted for BMI is reduced, bioimpedance analyses indicate increased gluteofemoral fat, and abdominal MRI analyses indicate reduced visceral adiposity. Co-localization analyses strongly correlate increased CHRDL1 gene expression, particularly in adipose tissue, with reduced concentrations of blood lipids. The influence of X chromosome genetic variation on blood lipids and coronary heart disease (CHD) is not well understood. Here, the authors analyse X chromosome sequencing data across 65,322 multi-ancestry individuals, identifying associations of the Xq23 locus with lipid changes and reduced risk of CHD and diabetes mellitus.Peer reviewe

Genome-wide SNP analysis reveals no gain in power for association studies of common variants in the Finnish Saami

The Saami from Fennoscandia are believed to represent an ancient, genetically isolated population with no evidence of population expansion. Theoretical work has indicated that under this demographic scenario, extensive linkage disequilibrium (LD) is generated by genetic drift. Therefore, it has been suggested that the Saami would be particularly suited for genetic association studies, offering a substantial power advantage and allowing more economic study designs. However, no study has yet assessed this claim. As part of a GWAS for a complex trait, we evaluated the relative power for association studies of common variants in the Finnish Saami. LD patterns in the Saami were very similar to those in the non-African HapMap reference panels. Haplotype diversity was reduced and, on average, levels of LD were higher in the Saami as compared with those in the HapMap panels. However, using a ‘hidden' SNP approach we show that this does not translate into a power gain in association studies. Contrary to earlier claims, we show that for a given set of common SNPs, genomic coverage attained in the Saami is similar to that in the non-African HapMap panels. Nevertheless, the reduced haplotype diversity could potentially facilitate gene identification, especially if multiple rare variants play a role in disease etiology. Our results further indicate that the HapMap is a useful resource for genetic studies in the Saami

A genome-wide analysis of population structure in the Finnish Saami with implications for genetic association studies

The understanding of patterns of genetic variation within and among human populations is a prerequisite for successful genetic association mapping studies of complex diseases and traits. Some populations are more favorable for association mapping studies than others. The Saami from northern Scandinavia and the Kola Peninsula represent a population isolate that, among European populations, has been less extensively sampled, despite some early interest for association mapping studies. In this paper, we report the results of a first genome-wide SNP-based study of genetic population structure in the Finnish Saami. Using data from the HapMap and the human genome diversity project (HGDP-CEPH) and recently developed statistical methods, we studied individual genetic ancestry. We quantified genetic differentiation between the Saami population and the HGDP-CEPH populations by calculating pair-wise FST statistics and by characterizing identity-by-state sharing for pair-wise population comparisons. This study affirms an east Asian contribution to the predominantly European-derived Saami gene pool. Using model-based individual ancestry analysis, the median estimated percentage of the genome with east Asian ancestry was 6% (first and third quartiles: 5 and 8%, respectively). We found that genetic similarity between population pairs roughly correlated with geographic distance. Among the European HGDP-CEPH populations, FST was smallest for the comparison with the Russians (FST=0.0098), and estimates for the other population comparisons ranged from 0.0129 to 0.0263. Our analysis also revealed fine-scale substructure within the Finnish Saami and warns against the confounding effects of both hidden population structure and undocumented relatedness in genetic association studies of isolated populations