Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Sensorineural Hearing Loss in Community-Dwelling Adults: an NHANES Analysis

Purpose: Sensorineural hearing loss (SNHL) is prevalent among older adults in the United States. Recent studies suggest the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as a potential marker for metabolic and cardiovascular conditions. Our research investigates the association between the TG/HDL-C ratio and SNHL using a comprehensive national dataset.

Materials and methods: This cross-sectional study utilized the National Health and Nutrition Examination Survey (NHANES) data cycle 1999-2000, 2001-2002, 2003-2004, 2011-2012, and 2015-2016. Participants aged 50-69 years with complete audiometry and TG/HDL-C data were included. The outcome was the presence of SNHL, defined as an average hearing threshold >25 dB in the better ear. We employed multivariate logistic regression adjusted for demographics, smoking, noise exposure, and comorbidities to explore the association.

Results: A total of 1148 participants constituted the analytic sample, and 31.4% had SNHL. Compared to no SNHL, those with SNHL exhibited higher TG/HDL-C ratios (3.5 vs. 2.7). Elevated TG/HDL-C tertiles correlated with increased SNHL odds [tertile 2: adjusted odds ratio (aOR)=1.50, 95% confidence interval (CI): 0.97-2.32, p=0.069; tertile 3: aOR=1.64, 95% CI: 1.03-2.63, p=0.039]. The link was stronger in participants without diabetes or obesity, with significant predictive values for SNHL presence (area under the ROC curve=0.716 and 0.753, respectively).

Conclusion: A higher TG/HDL-C ratio was significantly associated with SNHL in US adults aged 50-69 years, especially in those free from diabetes or obesity. These findings support considering TG/HDL-C as a useful marker for SNHL risk, highlighting the importance of combined metabolic and auditory health assessments.