Association Between Cystatin C and 20-Year Cumulative Incidence of Hearing Impairment in the Epidemiology of Hearing Loss Study

Schubert, Carla R.; Paulsen, Adam; Nondahl, David M.; Dalton, Dayna S.; Fischer, Mary; Klein, Barbara E. K.; Klein, Ronald; Tweed, Ted S.; Cruickshanks, Karen J.

doi:10.1001/jamaoto.2018.0041

Cited by 8 publications

(14 citation statements)

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“…Similar to previous reports, cumulative incidence of HI was common in these analyses . In this longitudinal study of the aging senses, there were no significant long‐term protective effects of serum aldosterone, IGF1, or BDNF against incident HI or changes in PTA overall.…”

Section: Discussionsupporting

confidence: 89%

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Neuroprotective factors and incident hearing impairment in the epidemiology of hearing loss study

et al. 2019

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Objective Hearing impairment (HI) is common in aging adults. Aldosterone, insulin‐like growth factor (IGF1), and brain‐derived neurotrophic factor (BDNF) have been identified as potentially protective of hearing. The present study aims to investigate these relationships. Methods The Epidemiology of Hearing Loss Study is a longitudinal population‐based study of aging in Beaver Dam, Wisconsin, that began in 1993. Baseline for the present investigation is the 1998 to 2000 phase. Follow‐up exams occurred approximately every 5 years, with the most recent occurring from 2013 to 2016. Hearing was measured by pure‐tone audiometry. HI was defined as a pure tone average (PTA) > 25 decibels hearing level in either ear. Change in PTA was the difference between follow‐up examinations and baseline. Baseline serum samples were used to measure biomarkers in 2017. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to assess the effect of biomarker levels in the lowest quintile (Q1) versus the highest (Q5) on incident HI and PTA change. Results There were 1,088 participants (69.3% women) at risk of HI included in analyses. The mean baseline age was 63.8 years (standard deviation = 7.0). The 16‐year incidence of HI was 54.9% and was higher in men (61.1%) than women (52.1%). In age‐ and sex‐adjusted models, aldosterone (HR = 1.06, 95% CI = 0.82–1.37), IGF1 (HR = 0.92, 95% CI = 0.71–1.19), and BDNF (HR = 0.86, 95% CI = 0.66–1.12) levels were not associated with risk of HI. PTA change was similarly not affected by biomarker levels. Conclusion Aldosterone, IGF1, and BDNF were not associated with decreased risk of age‐related hearing loss in this study. Level of Evidence 2b Laryngoscope, 129:2178–2183, 2019

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Section: Discussionsupporting

confidence: 89%

“…Recruitment and demographic details of the Epidemiology of Hearing Loss Study (EHLS) have been previously reported . Briefly, participants were residents of Beaver Dam, Wisconsin, aged 43 to 84 years as per a private census from 1987 to 1988.…”

Section: Methodsmentioning

confidence: 99%

Neuroprotective factors and incident hearing impairment in the epidemiology of hearing loss study

et al. 2019

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“…Schubert et al examined the longitudinal association between CysC concentration and eGFR CysC with hearing loss (n = 863) . Whereas a higher concentration of CysC was associated with hearing loss in a model adjusted for age and sex, there was no significant association after adjusting for additional potential confounders.…”

Section: Discussionmentioning

confidence: 99%

“…Data on the temporal association between renal function and hearing loss are limited. Investigators from the Epidemiology of Hearing Loss Study (EHLS) previously showed that lower estimated glomerular filtration rate calculated using cystatin C (eGFR CysC ) was significantly associated with a higher cumulative incidence of hearing loss (multivariable‐adjusted hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.02 to 2.22; <60 vs. ≥60 mL/minute/1.73 m 2 ) . In that study, hearing loss was defined as pure tone average (PTA) > 25 decibels hearing loss (dB HL) for thresholds at frequencies of 0.5, 1, 2, and 4 kHz (PTA 0.5,1,2,4 ) in either ear.…”

Section: Introductionmentioning

confidence: 99%

“…Investigators from the Epidemiology of Hearing Loss Study (EHLS) previously showed that lower estimated glomerular filtration rate calculated using cystatin C (eGFR CysC ) was significantly associated with a higher cumulative incidence of hearing loss (multivariable-adjusted hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.02 to 2.22; <60 vs. ≥60 mL/minute/1.73 m 2 ). 6 In that study, hearing loss was defined as pure tone average (PTA) > 25 decibels hearing loss (dB HL) for thresholds at frequencies of 0.5, 1, 2, and 4 kHz (PTA 0.5,1,2,4 ) in either ear. Although cystatin C (CysC) has been shown to be a good predictor of adverse outcomes, including cardiovascular disease, heart failure, and mortality, [7][8][9] it may be a marker of adverse outcomes independent of renal function.…”

Section: Introductionmentioning

confidence: 99%

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Chronic kidney disease and the risk of incident hearing loss

et al. 2019

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Objectives There is a strikingly high prevalence of sensorineural hearing loss among patients with chronic kidney disease, with estimates ranging from 36% to 77%; however, longitudinal data are limited. We assessed whether lower baseline estimated glomerular filtration rate calculated using creatinine (eGFRCr), as well as decline in eGFRCr over time, were associated with incident hearing loss. Methods Serum creatinine was measured in 1,843 individuals aged 48 to 80 years without hearing loss at the start of the Epidemiology of Hearing Loss Study in 1993. Follow‐up creatinine assessments were conducted at 5 (n = 1,526) and 10 (n = 1,095) years. Hearing tests were conducted at baseline and at 5‐, 10‐, and 15‐year follow‐up visits. The risk of hearing loss was assessed as a function of baseline eGFRCr as well as a function of a 20% decline in eGFRCr between baseline and 5 years and between 5 and 10 years. Cox proportional hazards regression was used to examine the risk of incident speech‐frequency hearing loss, defined as pure tone average (PTA) > 25 decibels hearing loss for thresholds at 0.5, 1, 2, and 4 kHz (PTA0.5,1,2,4) in either ear. Results During 15,676 person‐years of follow up, there were 802 cases of incident hearing loss. There was no statistically significant association between lower baseline eGFRCr and risk of incident hearing loss. Decline in eGFRCr was also not associated with incident hearing loss at speech frequencies. Conclusion Overall, there was no significant association between eGFRCr or decline in eGFRCr using the serum creatinine‐based equation and risk of incident hearing loss. Level of Evidence 2 Laryngoscope, 130:E213–E219, 2020

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Extending the Ear-Kidney Association to Presbycusis

Monsell

2018

JAMA Otolaryngol Head Neck Surg

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Understanding the causes of presbycusis is a major goal of health research because it is such a common human condition. The ear-kidney association has been known at least since the early 20th century, when the Alport and branchio-otorenal syndromes were described. It was also noted that the cochlea and kidney share the presence of pericytes and podocytes in the glomeruli and inner ear, indicating similarities in microcirculation. The ear and kidney have in common some forms of organ-specific toxic effects (eg, due to treatment with aminoglycosides or cisplatin), and both organs are actively engaged in ion transport functions to maintain homeostasis. 1 On the other hand, there has been little evidence that the ear-kidney association might be important in presbycusis.Recent epidemiologic studies have suggested associations among diabetes, hypertension, hyperlipidemia, obesity, chronic kidney disease (CKD), and smoking and that some of these risk factors for systemic disease increase in prevalence with age. 1,2 It is a reasonable question whether these are also risk factors for sensorineural hearing loss (SNHL). Crosssectional studies have suggested associations between CKD and SNHL in middle-aged and older adults. 3 In this issue of JAMA Otolaryngology-Head & Neck Surgery, Schubert et al 3 report their results from the Beaver Dam longitudinal study of sensory disorders, which has the advantages of being based on a stable population and being able to follow the 20-year cumulative incidence of SNHL. Serum cystatin C samples were collected at baseline from 863 middle-aged and elderly participants. Cystatin C is a low-molecular-weight protein biomarker that has largely replaced serum creatinine in the estimation of glomerular filtration rate (GFR). 4 Audiometry evaluations (with pure-tone air and bone conduction) were conducted at baseline and at 5-year intervals for 20 years. Normal hearing was defined as an average of pure-tone hearing thresholds at 0.5, 1, 2, and 4 kHz less than 25 dB in both ears using American National Standards Institute and American Speech-Language-Hearing Association standard audiometric methods. Chronic kidney disease was defined as an estimated GFR calculated using cystatin C (eGFR CysC ) less than 60 mL/min/1.73 m 2 . These data were analyzed in statistical models to explore the potential association between CKD and HL. Schubert et al 3 reported that "low eGFR CysC was significantly associated with the 20-year cumulative incidence of [hearing impairment] in

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Association Between Cystatin C and 20-Year Cumulative Incidence of Hearing Impairment in the Epidemiology of Hearing Loss Study

Abstract: Reduced kidney function as estimated using cystatin C, but not cystatin C alone, was associated with the 20-year cumulative incidence of HI, suggesting that some age-related HI may occur in conjunction with or as the result of reduced kidney function.

Cited by 8 publications

References 47 publications

Neuroprotective factors and incident hearing impairment in the epidemiology of hearing loss study

Neuroprotective factors and incident hearing impairment in the epidemiology of hearing loss study

Chronic kidney disease and the risk of incident hearing loss

Extending the Ear-Kidney Association to Presbycusis

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