Potential mediators of diabetes-related hearing impairment

OBJECTIVE — We examined potential mediators of the reported association between dia-betes and hearing impairment. RESEARCH DESIGN AND METHODS — Data come from 1,508 participants, aged 40–69 years, who completed audiometric testing during 1999–2004 in the National Health and Nutrition Examination Survey (NHANES). We defined hearing impairment as the pure-tone average 25 decibels hearing level of pure-tone thresholds at low/mid (500, 1,000, and 2,000 Hz) and high (3,000, 4,000, 6,000, and 8,000 Hz) frequencies. Using logistic regression, we examined whether controlling for vascular or neuropathic conditions, cardiovascular risk fac-tors, glycemia, or inflammation diminished the association between diabetes and hearing impairment. RESULTS — Diabetes was associated with a 100 % increased odds of low/mid-frequency hearing impairment (odds ratio 2.03 [95 % CI 1.32–3.10]) and a 67 % increased odds of high-frequency hearing impairment (1.67 [1.14–2.44]) in preliminary models after controlling for age, sex, race/ethnicity, education, smoking, and occupational noise exposure. Adjusting for peripheral neuropathy attenuated the association with low/mid-frequency hearing impairmen