Association between low bone mineral density and hearing impairment in postmenopausal women: the Korean National Health and Nutrition Examination Survey

OBJECTIVE To investigate the relationship between bone mineral density (BMD) and hearing impairment using a nationally demonstrative sample of Korean female adults. STUDY DESIGN Cross-sectional study of a national health survey. METHODS Data from the 2009-2010 Korean National Health and Nutrition Examination Surveys (KNHANES) with 19 491 participants were analysed, and 8773 of these participants were enrolled in this study. BMD was measured using dual-energy X-ray absorptiometry. Auditory functioning was evaluated by pure-tone audiometric testing according to established KNHANES protocols. We deliberated auditory impairment as pure-tone averages at frequencies of 0.5, 1.0, 2.0 and 3.0 kHz at a threshold of ≥40 decibels hearing level in the auricle with better hearing status. RESULTS Among women aged 19 years and older, prevalences of bilateral hearing impairment in premenopausal and postmenopausal women were 0.1%±0.1% and 11.5%±1.1% (mean±SE), respectively. Hearing impairment was meaningfully associated with low BMD in postmenopausal women. Logistic regression models indicated that lower BMDs of the total femur (OR=0.779; 95% CI 0.641 to 0.946, P=0.0118) and femur neck (OR=0.746; 95% CI 0.576 to 0.966, P=0.0265) were significantly associated with hearing impairment among postmenopausal women. CONCLUSIONS Postmenopausal Korean women with low BMD of the total femur and femoral neck showed an increased risk for developing hearing impairment. Further epidemiological and investigational studies are needed to elucidate this association.