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Original Investigation |

Sudden Sensorineural Hearing Loss Associated With Iron-Deficiency Anemia:  A Population-Based Study

Shiu-Dong Chung, MD, PhD1,2; Po-Yueh Chen, MD3; Herng-Ching Lin, PhD2,4; Shih-Han Hung, MD5
[+] Author Affiliations
1Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
2Sleep Research Center, Taipei Medical University, Taipei, Taiwan
3Department of Otolaryngology, Taipei Medical University–Shuang Ho Hospital, Taipei, Taiwan
4School of Medical Laboratory Sciences and Biotechnology, Taipei Medical University, Taipei, Taiwan
5Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan
JAMA Otolaryngol Head Neck Surg. 2014;140(5):417-422. doi:10.1001/jamaoto.2014.75.
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Importance  Vascular events play a big part in the development of sudden sensorineural hearing loss (SSNHL), but only those associated with sickle-cell anemia have been previously associated with SSNHL. This study demonstrates an association between SSNHL and prior iron-deficiency anemia (IDA).

Objective  To evaluate the association between IDA and SSNHL using a nationwide population-based database.

Design, Setting, and Participants  In this case-control study in Taiwan, participants with SSNHL (n = 4004) were identified, and controls (n = 12 012) were randomly selected.

Main Outcomes and Measures  Conditional logistic regression was used to calculate the ORs (95% CIs) for IDA in participants with SSNHL vs controls.

Results  Of the 16 016 sampled participants, 533 (3.3%) had previously been diagnosed with IDA, including 172 (4.3%) participants with SSNHL and 361 (3.0%) controls. The χ2 test revealed a significant difference (P < .001) in the prevalence of prior IDA between participants with SSNHL and controls. By conditional logistic regression, we found that the OR for previous IDA among the participants with SSNHL was 1.34 (95% CI, 1.11-1.61) (P < .01) after adjusting for monthly income, geographic region, urbanization level, and comorbidities (ie, hypertension, diabetes, hyperlipidemia, renal disease, and coronary heart disease). The significant relationship between SSNHL and prior IDA was most pronounced among those 44 years or younger (adjusted OR, 1.91; 95% CI, 1.35-2.72) (P < .001) for the participants with SSNHL compared with controls, and the strength of this relationship decreased with age.

Conclusions and Relevance  There is an association between SSNHL and prior IDA. Patients with IDA, especially those younger than 60 years, should be more aggressively surveyed and managed to reduce hearing-related morbidities.

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