title: Smoking, central adiposity, and poor glycemic control increase risk of hearing impairment.
abstract: OBJECTIVE
  To determine associations between smoking, adiposity, diabetes mellitus, and other risk factors for cardiovascular disease (CVD) and the 15-year incidence of hearing impairment (HI).
  
  
  METHODS
  A longitudinal population-based cohort study (1993-95 to 2009-10), the Epidemiology of Hearing Loss Study (EHLS).
  
  
  METHODS
  Beaver Dam, Wisconsin.
  
  
  METHODS
  Participants in the Beaver Dam Eye Study (1988-90; residents of Beaver Dam, WI, aged 43-84 in 1987-88) were eligible for the EHLS. There were 1,925 participants with normal hearing at baseline.
  
  
  METHODS
  Fifteen-year cumulative incidence of HI (pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz greater than 25 decibels hearing level in either ear). Cigarette smoking, exercise, and other factors were ascertained according to questionnaire. Blood pressure, waist circumference, body mass index, and glycosylated hemoglobin were measured.
  
  
  RESULTS
  Follow-up examinations (≥1) were obtained from 87.2% (n=1,678; mean baseline age 61). The 15-year cumulative incidence of HI was 56.8%. Adjusting for age and sex, current smoking (hazard ratio (HR)=1.31, P=.048), education (<16 years; HR=1.35, P=.01), waist circumference (HR=1.08 per 10 cm, P=.02), and poorly controlled diabetes mellitus (HR=2.03, P=.048) were associated with greater risk of HI. Former smokers and people with better-controlled diabetes mellitus were not at greater risk.
  
  
  CONCLUSIONS
  Smoking, central adiposity, and poorly controlled diabetes mellitus predicted incident HI. These well-known risk factors for CVD suggest that vascular changes may contribute to HI in aging. Interventions targeting reductions in smoking and adiposity and better glycemic control in people with diabetes mellitus may help prevent or delay the onset of HI.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin at Madison, Madison, Wisconsin.|Department of Population Health Sciences, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Cruickshanks
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: David M
authors.initials: DM
authors.lastname: Nondahl
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: Dayna S
authors.initials: DS
authors.lastname: Dalton
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Fischer
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.affiliation: Department of Population Health Sciences, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Nieto
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: Carla R
authors.initials: CR
authors.lastname: Schubert
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin at Madison, Madison, Wisconsin.|Department of Communication Sciences and Disorders, University of Wisconsin at Madison, Madison, Wisconsin.
authors.forename: Ted S
authors.initials: TS
authors.lastname: Tweed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D048909:Diabetes Complications / Q000097:blood / Q000150:complications*; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014922:Wisconsin
chemical_list: D001786:Blood Glucose
keywords: adiposity; diabetes mellitus; presbycusis; risk factors; smoking