职业性噪声性听力损失与代谢综合征的关联

Association between occupational noise-induced hearing loss and metabolic syndrome

[背景]职业性噪声性听力损失(ONHL)是一种复杂的疾病,影响着众多劳动者的健康,代谢综合征(MetS)也已成为导致全球疾病负担加重的主要因素,开展ONHL与MetS关联的研究意义重大。[目的]探讨ONHL与Met S的关系,为制定职业性噪声暴露人群的听力损失和MetS的干预措施和防治策略提供科学依据。[方法]采用整群抽样的方法,以某大型机械维修企业1145名男性职业性噪声暴露人群为研究对象。按是否存在高频听力损失,将调查对象分为听力正常组(699人)和听力损失组(446人)。通过问卷调查收集调查对象的一般人口学特征、职业史、家族史、既往史、个人生活行为等资料,通过职业健康检查获得体重指数(BMI)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、血压和空腹血糖(FPG)等数据。使用非条件多因素logistic回归方法分析ONHL与MetS患病之间的关联,计算各危险因素的OR及95%CI。[结果]在1145名职业性噪声接触工人中,听力损失检出率为38.95%,听力损失检出率随接噪工龄的增长而呈增加的趋势(P<0.001)。对临床指标分析发现,听力损失组FPG水平高于听力正常组(P<0.001)。听力损失组人群高TG血症、高血压、高血糖和MetS的检出率均高于听力正常组(P<0.01)。多因素logistic回归分析结果显示,在排除其他混杂因素影响后,MetS是导致ONHL发生的独立危险因素(OR=1.48,95%CI:1.12~1.95,P=0.005),同时接噪工龄长、已婚、文化程度低也是ONHL的危险因素(P<0.01)。[结论]ONHL与MetS的发生有关联,Met S可能是影响ONHL发生发展的独立危险因素,采取MetS预防干预措施可能是降低ONHL发病风险的有效手段。

[Background]Occupational noise-induced hearing loss(ONHL)is a complex disease that affects the health of numerous workers,and metabolic syndrome(MetS)has become a major contributor to global disease burden.It is of great significance to study the relationship between ONHL and MetS.[Objective]This study investigates the association between ONHL and MetS,aiming to provide a scientific basis for formulating intervention measures and control strategies against ONHL and MetS in noise-exposed workers.[Methods]A total of 1145 male workers in a large-scale mechanical maintenance enterprise were selected as study subjects by cluster sampling method,and were divided into a control group(n=699)and a case group(n=446)according to whether they were diagnosed with high frequency hearing loss.Data on general demographic characteristics,occupational history,family history,medical history,and life styles were collected through questionnaire survey,data on body mass index(BMI),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),blood pressure,and fasting blood glucose(FPG)were obtained through routine occupational health examination.The association between ONHL and MetS was assessed by non-conditional multiple logistic regression models,and the results were expressed as OR with 95%CI.[Results]Among the 1145 workers exposed to noise,the positive rate of hearing loss was 38.95%,and increased with longer years of noise exposure(P<0.001).The FPG level in the case group was higher than that in the control group(P<0.001).The positive rates of hypertriglyceridemia,hypertension,hyperglycemia,and MetS in the case group were higher than those in the control group(P<0.01).The multiple logistic regression analysis results showed that MetS was an independent risk factor for ONHL(OR=1.48,95%CI:1.12-1.95,P=0.005)after adjusting for selected confounding factors;in addition,longer years of noise exposure,married,and lower educational level were also the risk factors for ONHL(P<0.01).[Conclusion]ONHL is associated with MetS.MetS may be an independent risk factor for the development of ONHL.Preventive interventions for MetS may be effective in reducing a partial risk of ONHL.