中性粒淋巴细胞比值与成年人听力损失及听力阈值的关系:基于NHANES数据库的横断面研究

doi:10.6040/j.issn.1673-3770.0.2025.206

摘要/Abstract

摘要： 目的基于美国国家健康与营养调查2005—2010年及2015—2018年五个周期的数据,探究中性粒淋巴细胞比值(neutrophil lymphocyte ratio, NLR)与成年人听力损失及低频、言语和高频纯音测听平均阈值(pure tone average, PTA)的相关性。方法采用横断面研究设计,纳入符合标准的成年人群数据。采用多元Logistic回归分析评估NLR与听力损失的相关性,多元线性回归分析评估NLR与低频、言语及高频PTA的相关性。采用平滑曲线拟合探究NLR与听力损失和低频、言语及高频PTA之间的分段线性关系,并通过阈值效应分析确定拐点值。结果研究共纳入5 004例样本量。调整混杂变量后,NLR每升高1个单位,听力损失的患病率增加11%(OR=1.11,95%CI:1.02~1.21),差异具有统计学意义。NLR与低频,言语及高频PTA均呈正相关(β=0.78 dB、0.83 dB、1.00 dB),差异均具有统计学意义。平滑曲线拟合和阈值效应分析显示,NLR与低频及言语PTA存在分段线性关系,拐点位于4.19。当NLR<4.19时NLR与低频及言语PTA呈正相关(β=1.15 dB、1.16 dB),差异具有统计学意义;当NLR≥4.19时,差异无统计学意义。结论 NLR升高与成年人听力损失患病率增加及听阈阈值升高相关,提示炎症反应可能在听力损伤病理过程中起重要作用,NLR作为评估听力损失风险的潜在生物标志物具有探索价值,值得临床研究进一步验证。

关键词: 中性粒淋巴细胞比值, 听力损失, 美国国家健康与营养调查数据库, 横断面研究

Abstract: Objective To investigate the association between the neutrophil-to-lymphocyte ratio(NLR)and hearing loss, as well as the average thresholds of low-, speech-and high-frequency pure-tone average(PTA), in adults. It is based on data from the National Health and Nutrition Examination Survey from 2005-2010 and 2015-2018. Methods A cross-sectional study design was adopted to include data from the eligible adult population. Multiple logistic regression analysis was employed to evaluate the association between NLR and hearing loss. Multiple linear regression analysis was used to evaluate the association between NLR and low-frequency, speech-and high-frequency PTA. Smoothing curve fitting was employed to investigate the piecewise linear relationship between NLR and hearing loss, as well as low-frequency, speech and high-frequency PTA. Threshold effect analysis was then used to determine the inflection point. Results The analysis included 5,004 participants. After adjusting for confounding variables, the prevalence of hearing loss increased by 11%(OR=1.11,95%CI:1.02-1.21)for every one-unit increase in NLR, and this difference was statistically significant. NLR was positively correlated with low-frequency, speech, and high-frequency PTA(β=0.78 dB, 0.83 dB, 1.00 dB), and these differences were statistically significant. Smooth curve fitting and threshold effect analysis revealed a piecewise linear relationship between NLR and low-frequency and speech PTA, with an inflection point at 4.19. When NLR<4.19, NLR was positively correlated with low- frequency and speech PTA(β=1.15 dB, 1.16 dB), and the difference was statistically significant. When NLR ≥ 4.19, however, the difference was not statistically significant. Conclusion An increased NLR is associated with an increased prevalence of hearing loss and a higher hearing threshold in adults. This suggests that the inflammatory response may play an important role in the pathological process of hearing loss. As a potential biomarker for assessing risk, the NLR is exploratory and worthy of further verification in clinical studies.

Key words: Neutrophil lymphocyte ratio, Hearing loss, NHANES, Cross-sectional study

中图分类号:

R764.5

王凯健,王威,陈雪生,樊春笋,何颖颖,黄冬玲,钱村慧,丁树军. 中性粒淋巴细胞比值与成年人听力损失及听力阈值的关系:基于NHANES数据库的横断面研究[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 18-28.

WANG Kaijian, WANG Wei, CHEN Xuesheng, FAN Chunsun, HE Yingying, HUANG Dongling, QIAN Cunhui, DING Shujun. Correlation between neutrophil-to-lymphocyte ratio with hearing loss and audiometric thresholds in adults: a cross-sectional study based on NHANES[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(2): 18-28.

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