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Peer-reviewedCC BYAmerican Journal of Otolaryngology

Association between monocyte-to-high-density lipoprotein cholesterol ratio and hearing loss: A cross-sectional study based on NHANES

  1. 1Department of Otolaryngology, Peking University Third Hospital Yanqing Hospital, Beijing, 102100, China
  2. 2Corresponding author at: Peking University Third Hospital Yanqing Hospital, No. 28 Dongshuncheng Street, Yanqing District, Beijing, 102100, China.

Abstract

Background: This study aimed to unravel the association of the monocyte-to-high-density lipoprotein cholesterol (HDL-C) ratio (MHR) with different hearing loss (HL) types among American adults and assess the potential of MHR as a predictive HL biomarker. Methods: 2001–2006, 2009–2012, and 2015–2020 NHANES data were analyzed. The possible relations of MHR to speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) were unveiled leveraging weighted univariate and multivariate logistic regression (LR) models. Possible nonlinear relations of MHR to SFHL and HFHL were explored utilizing restricted cubic spline (RCS) regression. Heterogeneity across varied population characteristics was examined via subgroup analyses and interaction tests. Finally, the discriminative performance of the fully adjusted model for SFHL and HFHL was evaluated through receiver operating characteristic (ROC) curve analysis. Results: Our study encompassed 12,030 participants, among whom 3387 (24.11%) had SFHL and 5817 (44.66%) had HFHL. LR analysis showed that, after adjusting for all covariates, MHR was markedly positively related to HFHL [OR (95% CI): 1.66 (1.26, 2.19)] and SFHL [OR (95% CI): 1.73 (1.26, 2.38)]. RCS analysis indicated linear relationships between MHR and both HFHL and SFHL (P for nonlinear>0.05). Interaction analyses revealed significant interactions of race (P for interaction = 0.026) and BMI (P for interaction = 0.029) in the MHR-HFHL relation. ROC curve analysis based on Model 3 demonstrated good discriminative ability for HFHL and SFHL, with the areas under the curve (AUCs) of 0.908 (95% CI: 0.903–0.913) and 0.883 (95% CI: 0.876–0.890), respectively. Conclusion: MHR is positively associated with HL risk. As an easily accessible inflammation-related biomarker, MHR may help reflect the presence of HL, but its value in risk assessment requires further validation in prospective studies.

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BibTeX
@article{hao2026association,
  title = {{Association between monocyte-to-high-density lipoprotein cholesterol ratio and hearing loss: A cross-sectional study based on NHANES}},
  author = {Xue Hao and Na Zhao and Yufang Tan and Ying Luo and Ning Luan},
  journal = {American Journal of Otolaryngology},
  year = {2026},
  month = oct,
  doi = {10.1016/j.amjoto.2026.104974},
  url = {https://doi.org/10.1016/j.amjoto.2026.104974},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Association between monocyte-to-high-density lipoprotein cholesterol ratio and hearing loss: A cross-sectional study based on NHANES
AU  - Xue Hao
AU  - Na Zhao
AU  - Yufang Tan
AU  - Ying Luo
AU  - Ning Luan
PY  - 2026
DA  - 2026/10/30
JO  - American Journal of Otolaryngology
DO  - 10.1016/j.amjoto.2026.104974
UR  - https://doi.org/10.1016/j.amjoto.2026.104974
AB  - Background: This study aimed to unravel the association of the monocyte-to-high-density lipoprotein cholesterol (HDL-C) ratio (MHR) with different hearing loss (HL) types among American adults and assess the potential of MHR as a predictive HL biomarker. Methods: 2001–2006, 2009–2012, and 2015–2020 NHANES data were analyzed. The possible relations of MHR to speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) were unveiled leveraging weighted univariate and multivariate logistic regression (LR) models. Possible nonlinear relations of MHR to SFHL and HFHL were explored utilizing restricted cubic spline (RCS) regression. Heterogeneity across varied population characteristics was examined via subgroup analyses and interaction tests. Finally, the discriminative performance of the fully adjusted model for SFHL and HFHL was evaluated through receiver operating characteristic (ROC) curve analysis. Results: Our study encompassed 12,030 participants, among whom 3387 (24.11%) had SFHL and 5817 (44.66%) had HFHL. LR analysis showed that, after adjusting for all covariates, MHR was markedly positively related to HFHL [OR (95% CI): 1.66 (1.26, 2.19)] and SFHL [OR (95% CI): 1.73 (1.26, 2.38)]. RCS analysis indicated linear relationships between MHR and both HFHL and SFHL (P for nonlinear>0.05). Interaction analyses revealed significant interactions of race (P for interaction = 0.026) and BMI (P for interaction = 0.029) in the MHR-HFHL relation. ROC curve analysis based on Model 3 demonstrated good discriminative ability for HFHL and SFHL, with the areas under the curve (AUCs) of 0.908 (95% CI: 0.903–0.913) and 0.883 (95% CI: 0.876–0.890), respectively. Conclusion: MHR is positively associated with HL risk. As an easily accessible inflammation-related biomarker, MHR may help reflect the presence of HL, but its value in risk assessment requires further validation in prospective studies.
SN  - 1532-818X
SN  - 0196-0709
ER  -