Association Between Accumulation of Advanced Glycation End-Products and Hearing Impairment in Community-Dwelling Older People: A Cross-Sectional Sukagawa Study

Abstract

Objectives: The experimental studies suggested the hypothesis that the accumulation of advanced glycation end-products (AGEs) could induce hearing impairment. The purpose of this study is to examine the hypothesis among elderly people using an epidemiologic approach.

Design: Cross-sectional study.

Setting: Sukagawa City, Fukushima, Japan.

Participants: A total of 270 residents aged 75 years or over without dementia, who participated in a health check-up conducted in 2015.

Measurements: The exposure variable was AGEs, which was assessed using skin autofluorescence (AF) as a proxy measure. The primary outcome was moderate hearing impairment or worse, which was defined as a pure tone average of thresholds ≥41 decibel hearing level at 0.5, 1, 2, and 4 kHz in the better-hearing ear. The secondary outcome was the pure tone average of thresholds as a continuous variable. We estimated the odds ratio using a logistic regression model for the primary outcome and a general linear model for the mean difference in the pure tone average of thresholds for the secondary outcome. Both models were adjusted for relevant confounding factors: age, sex, smoking, diabetes, hypertension, and history of cerebrovascular diseases.

Results: The median (interquartile range) AF was 2.2 (2.0, 2.5) arbitrary units (AU). Moderate hearing impairment was reported in 88 participants (32.6%). For the primary outcome, we found significant associations between moderate hearing impairment and AF (adjusted odds ratio per 1 AU, 2.60; 95% confidence interval 1.26-5.35). For the secondary outcome, we also found a significant association between a 1-AU increase in AF and increased pure tone average, with a difference (6.52 dB per 1 AU; 95% confidence interval 2.18-10.86) comparable in magnitude to the increase in pure tone average observed for a 6-year increase in age in our population.

Conclusions: Our study indicated that high levels of AGEs were independently associated with hearing impairment. Modifying levels of AGEs may prevent hearing impairment.

Keywords: Advanced glycation end-products; elderly; hearing impairment.