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目的 探讨脂代谢指标与噪声下言语识别困难之间的因果关系，并评估其在听力损失早期阶段的作用。方法 基于孟德尔随机化（Mendelian randomization,MR）设计，利用英国生物银行和全球脂质遗传学联盟两个大型全基因组关联分析数据库的数据，评估高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、低密度脂蛋白胆固醇、甘油三酯等脂代谢指标与噪声下言语识别困难之间的因果关联。采用逆方差加权方法作为主要分析方法，并通过多变量MR进一步验证脂代谢指标的独立贡献。结果 两样本MR分析表明，HDL-C与噪声下言语识别困难具有显著的保护性因果关系（英国生物银行数据集：OR=0.993,95%CI:0.987～0.999,P=0.014），这一关联在多变量分析中保持稳健（OR=0.992,95%CI:0.984～1.000,P=0.045）。相比之下，其他脂代谢指标未显示出显著的独立因果效应。此外，全球脂质遗传学联盟数据集中HDL-C的保护作用虽然显示出类似趋势，但未达到统计学显著性（OR=0.994,95%CI:0.987～1.000,P=0.054），多变量MR结果（OR=0.992,95%CI:0.983～1.000,P=0.064）。结论 HDL-C在噪声下言语识别困难中具有保护作用，HDL-C水平的改善可能通过抑制炎症、抗氧化和改善微循环等机制对听力健康产生积极影响。
Abstract：Objective To investigate the relationship between lipid metabolism markers and hearing difficulty in noise, as well as their roles in early stages of hearing loss. Methods Based on Mendelian randomization(MR) design, and using data from two large-scale genome-wide association study databases, i.e. the UK Biobank and the Global Lipids Genetic Consortium,associations between lipid metabolism indicators, such as high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), triglycerides, and speech recognition difficulties in noise were evaluated. The inverse-variance weighted method was employed as the primary analytical approach, and multivariable MR analysis was conducted to further validate the independent contribution of lipid metabolism markers. Results Two-sample MR analysis revealed a significant protective relationship between HDL-C and hearing difficulty in noise(UK Biobank dataset: OR=0.993, 95%CI: 0.987～0.999, P=0.014). This association remained robust in multivariable analysis(OR=0.992, 95%CI: 0.984～1.000, P=0.045). In contrast, other lipid metabolism markers did not demonstrate significant independent causal effects. Furthermore, while the protective effect of HDL-C in the Global Lipids Genetic Consortium dataset exhibited a similar trend, it did not reach statistical significance(OR=0.994, 95%CI: 0.987～1.000, P=0.054). Multivariable MR results also showed a marginal association(OR=0.992, 95%CI: 0.983～1.000, P=0.064). Conclusions HDL-C exhibits a protective role against hearing difficulty in noise. Improving HDL-C levels may positively impact hearing health by mechanisms such as suppressing inflammation, exerting antioxidant effects and improving microcirculation.
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基本信息:
中图分类号:R764
引用信息:
[1]曹扬,吴萧男,李丹阳,等.脂代谢与噪声下言语识别困难风险的孟德尔随机化分析[J].中华耳科学杂志,2026,24(01):20-25.
基金信息:
国家重点研发计划（2023YFC2508400,2023YFC2509800）
2026-01-12
2026-01-12