Abstract
BACKGROUND: This study aimed to investigate the relationship between the neutrophil-to-HDL cholesterol ratio (NHR) and the risk of hearing loss, as well as to evaluate the potential of the NHR as a biomarker for hearing loss. METHODS: The U.S. National Health and Nutrition Examination Survey (NHANES) data covering 2005-2012 and 2015-2020 were analyzed. A weighted multivariate logistic regression model assessed the correlation between NHR and speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL). Restricted cubic spline (RCS) regression analysis was utilized to investigate the nonlinear correlation. Additionally, subgroup analysis was performed to identify differences among subgroups. A receiver operating characteristic (ROC) analysis was conducted to evaluate the efficacy of NHR in predicting hearing loss. RESULTS: A total of 10,436 participants were involved. After comprehensive adjustments for confounding factors, NHR was linearly correlated with SFHL and HFHL. Subgroup analysis revealed that race and the poverty index ratio (PIR) significantly modified the association between NHR and hearing loss. ROC analysis demonstrated the predictive capability of NHR for hearing loss. CONCLUSION: NHR is positively correlated with the risk of hearing loss. This study suggests that NHR may serve as a potential biomarker for predicting and assessing hearing loss, demonstrating significant clinical application value. However, this cross-sectional study limits the ability to establish causality. Future longitudinal studies are needed to confirm these findings and explore potential mechanisms.