{
  "abstract": "ObjectiveTo examine whether bilateral four-frequency pure-tone average (PTA4) increased across operational cardiovascular-kidney-metabolic (CKM) stages and assess associations with individual CKM components.\n\nDesignCross-sectional National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 pre-pandemic analysis. Survey-weighted models adjusted for demographics, education, smoking, and noise exposure.\n\nStudy sampleAdults aged 70-79 years (n = 994); stage analysis n = 285; waist model n = 778.\n\nResultsCovariate-adjusted mean bilateral PTA4 thresholds did not increase consistently across stages. No planned Stage 2-4 comparison met the Holm criterion; Stage 4 minus Stage 3 was 4.45 dB HL (95% CI, - 0.61 to 9.51; Holm p = 0.246). Stage 2-4-only heterogeneity was not supported (p = 0.197). The five-stage omnibus was significant (p < 0.001), but inference was limited by sparse lower-stage support, including one Stage 0 participant. Waist circumference alone met the nine-test Holm criterion: +1.57 dB HL per 10 cm (95% CI, 0.74 to 2.39; Holm p = 0.00547).\n\nConclusionsGreater waist circumference was associated with higher PTA4, but this cross-sectional association does not establish a hearing benefit from reducing waist circumference. These data do not establish operational CKM stage as a graded indicator of PTA4 in adults aged 70-79 years.",
  "abstract_shown": true,
  "affiliations": [
    "University of Health Sciences - Vietnam National University Ho Chi Minh City"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "D. M. Le"
    },
    {
      "name": "S. T. Tran"
    },
    {
      "name": "V. C. Nguyen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/68wjy34fhys0k.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.11.26362649",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362649v1.full",
  "id": "68wjy34fhys0k",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362649v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "epidemiology"
    ],
    [
      "openalex",
      "2805|Hearing Loss and Rehabilitation"
    ]
  ],
  "openalex": "W7213443161",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362649v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-11",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/68wjy34fhys0k.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:47Z",
      "native_id": "10.64898/2026.09.11.26362649",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362649v2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "When CKM Syndrome Stage Is Not a Severity Scale: Audiometric Hearing Thresholds in Older U.S. Adults",
  "title_text": "When CKM Syndrome Stage Is Not a Severity Scale: Audiometric Hearing Thresholds in Older U.S. Adults",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:23Z",
  "url": "https://research.draconitic.com/paper/68wjy34fhys0k",
  "venue": "medRxiv",
  "versions": []
}