Association between a High-Potassium Diet and Hearing Thresholds in the Korean Adult Population.
ABSTRACT: The aim of this study was to determine and evaluate the association between potassium intake and hearing thresholds in the Korean adult population. Data from the Korean National Health and Nutrition Examination Survey were analyzed. Participants were divided into tertiles on the basis of their potassium intake as follows: low, middle, and high. Pure-tone audiometry was performed using an automated audiometer. We calculated as the average threshold at the low-frequency pure-tone average (0.5 and 1?kHz), mid-frequency pure-tone average (2 and 3?kHz), and high-frequency pure-tone average (4 and 6?kHz). The average hearing threshold (AHT) was calculated as the pure-tone average of the thresholds at 0.5~3?kHz. Hearing loss (HL) was defined as an AHT of >40?dB in the better ear. There were 1975 participants each in the low, middle, and high tertile groups. The four different average hearing thresholds significantly decreased with an increase in the potassium intake tertile. Multivariate analysis revealed that the four different average hearing thresholds were significantly lower in the high tertile group than in the other two groups. In addition, univariate and multivariate linear regression analyses showed that the potassium intake level was inversely associated with each of the four different average hearing thresholds. Analyses of participants matched based on propensity scores and participants not matched based on propensity scores yielded similar results. The results of this study suggest that high potassium intake levels were associated with a lower prevalence of HL and lower hearing thresholds in the Korean adult population.
Project description:Different guidelines are adopted in clinics and countries to assess pure tone hearing sensitivity in children with otitis media with effusion (OME). Some guidelines specify a broad range of audiometric frequencies that must be tested and from which average thresholds determined, while others leave test frequencies unspecified. For guidelines that suggest specific frequencies there are various pure tone frequencies and frequency ranges given. The present study investigated whether (1) a full range of audiometric frequencies is required to evaluate hearing loss caused by OME in children, or if neighboring frequencies provide essentially the same threshold information, and (2) if different combinations of test frequency pure tone averaging calculations may affect decision criteria for surgical treatment. In a retrospective cohort study, right and left ear air conduction pure tone threshold data were obtained, from 125 Hz to 8 kHz, for 96 children with OME aged 4 to 12 years. Paired t-tests, correlation tests (Pearson's r, Cronbach's alpha, intraclass correlation) and absolute differences were used to examine the relationships among pure tone audiometric (PTA) frequencies for all ears with hearing loss. 168 ears were found to have OME-related hearing loss. Only the 125 Hz-250 Hz comparison showed no statistically significant difference between neighboring thresholds. However, only the 4 kHz and 8 kHz comparison showed a clinically significant mean difference of ≥ 10 dB. When viewing individual differences, comparison between 250 Hz and 500 Hz, 125 Hz and 500 Hz, and 4 kHz and 8 kHz, showed a large number of ears with clinically significant differences between test frequencies. Comparisons among low frequency 3 PTA average (500 Hz, 1 kHz, 2 kHz), high frequency 3 PTA average (1 kHz, 2 kHz, 4 kHz), and 4 frequency PTA average (500 Hz, 1 kHz, 2 kHz, 4 kHz) showed no statistically significant differences, with very strong correlations for all comparisons. In addition, for all the combinations of PTA averages, no clinically significant differences were found for the various comparisons or among individual results. Clinically, testing hearing sensitivity in the 125 Hz to 8 kHz range is worthwhile in evaluating hearing sensitivity in children with OME due to large individual variability across audiometric frequencies. However, frequencies tested for criterion averages for surgical treatments of children with OME may be restricted to 3 frequency PTA averages, either an average of 500 Hz, 1 kHz, 2 kHz or an average of 1 kHz, 2 kHz, 4 kHz, as no clinically significant differences were found using these or a 4 frequency averaging technique. For research purposes, 250 Hz can proxy for hearing thresholds at 125 Hz; and the low frequency 3 PTA average, high frequency 3 PTA average and 4 frequency PTA average may be used interchangeably, as no statistically significant differences were found among these measures.
Project description:To estimate the short-term variability and correlates of variability in pure-tone thresholds obtained using audiometric equipment designed for occupational use, and to examine the justification for excluding 8 kHz as a mandatory threshold in occupational hearing conservation programs.Pure-tone thresholds and other hearing-related tests (e.g. noise dosimetry, otoscopy, middle-ear assessment) were conducted with a group of 527 adults between 20 and 69 years of age. Five measurement visits were completed by participants within 14 days.The 50% critical difference boundaries were - 5 and 0 dB at 4 kHz and below and - 5 and 5 dB at 6 and 8 kHz. The likelihood of spurious notches due to test-retest variability was substantially lower than the likelihood of failing to detect a notched configuration when present. Correlates of variability included stimulus frequency, baseline threshold, acoustic reflectance of the ear, average noise exposure during the previous eight hours, age, and the tester's level of education in audiology.The short-term variability in 8-kHz pure-tone thresholds obtained with the TDH-39P earphone was slightly greater than at other frequencies, but this difference was not large enough to justify the disadvantages stemming from the inability to detect a 6-kHz notch.
Project description:BACKGROUND:When evaluating hearing disability in medicolegal cases, an average of thresholds at several frequencies is calculated using pure tone audiometry. Occasionally, there are instances in which thresholds at certain frequencies are omitted. One typical example is the threshold at 3 kHz (H3k). The American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium (1995) suggested that the average of thresholds at 2 kHz and 4 kHz (H24k) could replace H3k for a comparison of results between studies. However, to the best of our knowledge, there is no report in the literature that compares H3k and H24k. OBJECTIVE:This study aimed to investigate the agreement between H3k and H24k. METHODS:This study is based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012, which was conducted by the Korean government. A total of 18,472 participants (unweighted) who represented 39,357,497 Koreans (weighted) were included. To verify the agreement of H3k and H24k, a paired t-test, Cohen's d, Pearson's correlation, Cronbach's coefficient, intraclass correlation coefficient (ICC), a Bland-Altman plot, and linear regression analysis were used. RESULTS:The means of H3k and H24k were 16.2 dBHL and 16.6 dBHL, respectively. They were significantly different in a paired t-test (p<0.0001), which resulted from the large sample size. In contrast, the effect size (Cohen's d) was 0.02, which meant that the two groups nearly overlapped. The means showed strong correlation: Pearson's correlation coefficient = 0.92, Cronbach's alpha = 0.96, and ICC = 0.92. A strong linear predictive relationship between H3k and H24k was found: y = -0.6821 + 1.0186x, where x = H24k, y = H3k, and p<0.0001. However, the Bland-Altman plot showed large upper and lower limits of agreement (LOA) of 15.0 dBHL and -15.8 dBHL, respectively. Irrespective of age and degree of the four-tone average (0.5, 1, 2, and 3 kHz) hearing loss or thresholds at 2 kHz, 3 kHz, and 4 kHz, the absolute LOAs were greater than 10 dBHL. CONCLUSIONS:Despite a very strong correlation between the two thresholds, H3k and H24k showed clinically large LOAs. Therefore, it would be improper to substitute H24k for H3k in an individual requesting a hearing disability rating. However, since the overall means of the H3k and H24k samples were nearly equal, H24k can replace H3k for a mean comparison of results between studies. This result supports the 1995 Committee on Hearing and Equilibrium guideline.
Project description:The protective effects of antioxidant vitamins on hearing loss are well established in animal studies but in few human studies. Recent animal studies suggest that magnesium intake along with antioxidants may act in synergy to prevent hearing loss.We examined associations between intake of antioxidant vitamins (daily ?-carotene and vitamins C and E) and magnesium and hearing thresholds and explored their joint effects in US adults.We analyzed cross-sectional data from 2592 participants aged 20-69 y from NHANES 2001-2004. Hearing thresholds as pure tone averages (PTAs) at speech (0.5, 1, 2, and 4 kHz) and high frequencies (3, 4, and 6 kHz) were computed.When examined individually, modeled as quartiles, and after adjustment for potential confounders, higher intakes of ?-carotene, vitamin C, and magnesium were associated with lower (better) PTAs at both speech and high frequencies. High intakes of ?-carotene or vitamin C combined with high magnesium compared with low intakes of both nutrients were significantly associated with lower (better) PTAs at high frequencies (-14.82%; 95% CI: -20.50% to -8.74% for ?-carotene + magnesium and -10.72%; 95% CI: -16.57% to -4.45% for vitamin C + magnesium). The estimated joint effects were borderline significantly larger than the sums of the individual effects [high ?-carotene/low magnesium (-4.98%) and low ?-carotene/high magnesium (-0.80%), P-interaction = 0.08; high vitamin C/low magnesium (-1.33%) and low vitamin C/high magnesium (2.13%), P-interaction = 0.09].Dietary intakes of antioxidants and magnesium are associated with lower risks of hearing loss.
Project description:<h4>Importance</h4>Hearing loss (HL), a major cause of disability globally, negatively affects both personal and professional life.<h4>Objective</h4>To describe the prevalence of sensorineural hearing loss (SNHL) among a population-based cohort of 9- to 11-year-old children, and to examine potential associations between purported risk factors and SNHL in early childhood.<h4>Design, setting, and participants</h4>The study was among the general, nonclinical, pediatric community within the city of Rotterdam, the Netherlands, and was conducted between 2012 and 2015 as a cross-sectional assessment within the Generation R Study, a population-based longitudinal cohort study from fetal life until adulthood. Participants are children of included pregnant women in the Generation R Study with an expected delivery date between April 2002 and January 2006. They form a prenatally recruited birth cohort.<h4>Main outcomes and measures</h4>Pure-tone air-conduction hearing thresholds were obtained at 0.5, 1, 2, 3, 4, 6, and 8 kHz, and tympanometry was performed in both ears. Demographic factors and parent-reported questionnaire data, including history of otitis media, were also measured.<h4>Results</h4>A total of 5368 participants with a mean age of 9 years 9 months (interquartile range, 9 years 7 months-9 years 11 months) completed audiometry and were included in the analyses. A total of 2720 were girls (50.7%), and 3627 (67.6%) were white. Most of the participants (4426 children [82.5%]) showed normal hearing thresholds 15 dB HL or less in both ears. Within the cohort, 418 children (7.8%) were estimated to have SNHL (?16 dB HL at low-frequency pure-tone average; average at 0.5, 1, and 2 kHz or high-frequency pure-tone average; average at 3, 4, and 6 kHz in combination with a type A tympanogram) in at least 1 ear, most often at higher frequencies. In multivariable analyses, a history of recurrent acute otitis media and lower maternal education were associated with the estimated SNHL at ages 9 to 11 years (odds ratio, 2.0 [95% CI. 1.5-2.8] and 1.4 [95% CI, 1.1-1.7], respectively).<h4>Conclusions and relevance</h4>Within this cohort study in the Netherlands, 7.8% of the children ages 9 to 11 years had low-frequency or high-frequency HL of at least 16 dB HL in 1 or both ears. A history of recurrent acute otitis media and lower maternal education seem to be independent risk factors for presumed SNHL in early childhood.
Project description:Although lead has been associated with hearing loss in occupational settings and in children, little epidemiologic research has been conducted on the impact of cumulative lead exposure on age-related hearing loss in the general population. We determined whether bone lead levels, a marker of cumulative lead exposure, are associated with decreased hearing ability in 448 men from the Normative Aging Study, seen between 1962 and 1996 (2264 total observations). Air conduction hearing thresholds were measured at 0.25-8 kHz and pure-tone averages (PTA) (mean of 0.5, 1, 2 and 4 kHz) were computed. Tibia and patella lead levels were measured using K X-ray fluorescence between 1991 and 1996. In cross-sectional analyses, after adjusting for potential confounders including occupational noise, patella lead levels were significantly associated with poorer hearing thresholds at 2, 3, 4, 6 and 8 kHz and PTA. The odds of hearing loss significantly increased with patella lead levels. We also found significant positive associations between tibia lead and the rate change in hearing thresholds at 1, 2, and 8 kHz and PTA in longitudinal analyses. Our results suggest that chronic low-level lead exposure may be an important risk factor for age-related hearing loss and reduction of lead exposure could help prevent or delay development of age-related hearing loss.
Project description:BACKGROUND AND OBJECTIVES:The present study aimed to compare thresholds of direct bone-conduction (BC direct) with those of behaviorally measured BC pure-tone audiometry (PTA) and objectively measured BC auditory brainstem response (ABR) to confirm the clinical feasibility of their relationships. Subjects and. METHODS:Young adults with normal hearing participated in the study to determine the thresholds from three measurements at four testing frequencies. In the BC direct, the vibrator of a bone-anchored hearing aid softband was placed on the right mastoid of each subject. In both PTA and ABR, a B71 bone oscillator was placed on the subject's right mastoid. While the subject's thresholds of BC direct and BC PTA were determined with a clinically routine 5-dB step procedure, BC ABR was conducted to determine the individual's hearing sensitivity by a peak V of the waveform using tone-burst and click stimuli. RESULTS:The BC direct showed a different pattern between low and high frequencies. Precisely, its thresholds were 13.25 and 12.25 dB HL at 0.5 and 1 kHz, respectively, but 19 and 19.75 dB HL at 2 and 4 kHz, respectively. A significant positive correlation existed between BC direct and PTA at 1 kHz, which was also correlated with ABR. CONCLUSIONS:Based on the current data, the thresholds of BC direct were similar to BC PTA at low frequencies and BC ABR at high frequencies. The thresholds of BC direct might be predictable at approximately 5 dB higher (or lower) than that in PTA, although a large data set is required for standardization.
Project description:Hearing impairment (HI) is prevalent, is modifiable, and has been associated with cognitive decline. We tested the hypothesis that audiometric HI measured in 2013 is associated with poorer cognitive function in 253 men and women from Washington County, Maryland (mean age = 76.9 years) in a pilot study carried out within the Atherosclerosis Risk in Communities Neurocognitive Study. Three cognitive tests were administered in 1990-1992, 1996-1998, and 2013, and a full neuropsychological battery was administered in 2013. Multivariable-adjusted differences in standardized cognitive scores (cross-sectional analysis) and trajectories of 20-year change (longitudinal analysis) were modeled using linear regression and generalized estimating equations, respectively. Hearing thresholds for pure tone frequencies of 0.5-4 kHz were averaged to obtain a pure tone average in the better-hearing ear. Hearing was categorized as follows: ?25 dB, no HI; 26-40 dB, mild HI; and >40 dB, moderate/severe HI. Comparing participants with moderate/severe HI to participants with no HI, 20-year rates of decline in memory and global function differed by -0.47 standard deviations (P = 0.02) and -0.29 standard deviations (P = 0.02), respectively. Estimated declines were greatest in participants who did not wear a hearing aid. These findings add to the limited literature on cognitive impairments associated with HI, and they support future research on whether HI treatment may reduce risk of cognitive decline.
Project description:Many reports have documented age-by-frequency increases in average auditory thresholds in various human populations. Despite this, the prevalence of different patterns of hearing loss in presbycusis remains uncertain. We examined 'presbycusis phenotypes' in a database of 960 subjects (552 female, 408 male, 18-92 years) that each had 30 measures of peripheral hearing sensitivity: pure tone audiograms for left and right ears from 0.25 to 8 kHz and DPOAE for each ear with F(mean)=1-6.4 kHz. Surprisingly, the hearing phenotypes did not naturally separate into discrete classes of presbycusis. Principal component (PC) analysis revealed that two principal components account for 74% of the variance among the 30 measures of hearing. The two components represent the overall degree (PC1) and configuration of loss (Flat vs. Sloping; PC2) and the phenotypes form a continuum when plotted against them. A heuristic partitioning of this continuum produced classes of presbycusis that vary in their degree of Sloping or Flat hearing loss, suggesting that the previously reported sub-types of presbycusis arise from the categorical segregation of a continuous and heterogeneous distribution. Further, most phenotypes lie intermediate to the extremes of either Flat or Sloping loss, indicating that if audiometric configuration does predict presbycusis etiology, then a mixed origin is the most prevalent.
Project description:OBJECTIVE:Railway workers performing maintenance work of trains and tracks could be at risk of developing noise-induced hearing loss, since they are exposed to noise levels of 75-90?dB(A) with peak exposures of 130-140?dB(C). The objective was to make a risk assessment by comparing the hearing thresholds among train and track maintenance workers with a reference group not exposed to noise and reference values from the ISO 1999. DESIGN:Cross-sectional. SETTING:A major Norwegian railway company. PARTICIPANTS:1897 and 2730 male train and track maintenance workers, respectively, all exposed to noise, and 2872 male railway traffic controllers and office workers not exposed to noise. OUTCOME MEASURES:The primary outcome was the hearing threshold (pure tone audiometry, frequencies from 0.5 to 8?kHz), and the secondary outcome was the prevalence of audiometric notches (Coles notch) of the most recent audiogram. RESULTS:Train and track maintenance workers aged 45?years or older had a small mean hearing loss in the 3-6?kHz area of 3-5?dB. The hearing loss was less among workers younger than 45?years. Audiometric notches were slightly more prevalent among the noise exposed (59-64%) group compared with controls (49%) for all age groups. They may therefore be a sensitive measure in disclosing an early hearing loss at a group level. CONCLUSIONS:Train and track maintenance workers aged 45?years or older, on average, have a slightly greater hearing loss and more audiometric notches compared with reference groups not exposed to noise. Younger (<45?years) workers have hearing thresholds comparable to the controls.