Association of systemic inflammatory biomarkers with hearing loss: Results from NHANES 1999–2020 analyses

Background :Hearing loss (HL) is a prevalent global health issue with a complex etiology in whichinflammation plays a significant role. The systemic immune inflammatory index (SII), a novel biomarker reflecting systemic inflammation, is hypothesized to correlate with HL. Methods : Utilizing National Health and Nutritional Health Survey (NHANES) data from 1999–2020, this study analyzed the relationship between the SII and HL, categorized ashigh-frequency hearing loss (HFHL) orspeech-frequency hearing loss (SFHL). Blood samples were collected to calculate the SII. Weighted multivariate linear and logistic regression analyses were used to examine the linear relationship between the SII and hearing loss. After the SII was categorized into quartiles, a trend test was applied to assess the linear association between the SII and HL. Subgroup analysis was conducted to explore the correlation between the SII and HL across different sexes. Results : Univariate logistic regression analysis revealed no significant correlation between the SII and the occurrence of hearing loss or SFHL (p>0.05), but there was a correlation between the SII and HFHL. Multivariate logistic regression revealed a significant positive correlation between the third quartile of the SII and hearing loss. In the second quartile, there was a significant positive correlation between the SII and SFHL. For HFHL, a significant positive correlation between the SII and HFHL was present only in the crude model and in the second and third quartiles. Stratified analysis of clinical variables revealed a positive correlation between SII and the onset of hearing loss in those with never alcohol intake and moderate alcohol intake, a positive correlation between the SII and HFHL in those with moderate alcohol intake,and a negative correlation between the SII and SFHL in those with a normal BMI, aged older than 60 years, and who were former smokers. In the RCSplot, a reverse U-shaped association was observed between the SII and the prevalence of hearing loss and SFHL (nonlinear p<0.05). There was a positive correlation between the SII and the incidence of HFHL. After stratification by sex, the SII showed a reverse U-shaped association with hearing loss in males and a positive correlation in females. Conclusion : The SII is positively correlated with HFHL and shows a potential U-shaped relationship with HL and SFHL. In males, there was a reverse U-shaped association between the SII and hearing loss, while in females, there was a positive correlation.