Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May-Jun;27(126):282-288.
doi: 10.4103/nah.nah_142_24. Epub 2025 Jun 26.

Conicity Index Associated with Adult Hearing Impairment: A Cross-Sectional Study Based on the National Health and Nutrition Examination Survey (2001-2018)

Guifen Cai  1 , Xiaoyan Xu  1 , Xiaokun Li  2 , Qiong Fang  1
Affiliations

Conicity Index Associated with Adult Hearing Impairment: A Cross-Sectional Study Based on the National Health and Nutrition Examination Survey (2001-2018)

Guifen Cai et al. Noise Health. 2025 May-Jun.

Abstract

Objective: This study aimed to evaluate the association of conicity index (C-index), a marker of abdominal obesity, with hearing impairment (HI) in US adults using data from the National Health and Nutrition Examination Survey (NHANES).

Methods: We conducted a cross-sectional investigation using data from nine NHANES cycles spanning from 2001 to 2018. The C-index was used as the independent variable, whereas HI-defined as a pure-tone average hearing threshold exceeding 25 dB HL-was the outcome measure. Multivariable logistic regression models were used to assess the association between C-index and HI, adjusting for potential confounders including age, sex, race/ethnicity, hypertension, diabetes, total cholesterol, haemoglobin and blood urea nitrogen. Dose-response relationships were evaluated using trend tests (P for trend) and restricted cubic spline (RCS) analysis. Subgroup analyses were performed to assess potential interaction effects.

Results: A total of 7394 adults aged 20-69 were included. Higher C-index values were significantly associated with an increased prevalence of HI. In the fully adjusted model, each unit increase in C-index was associated with 7.35-fold higher odds of HI (95% CI: 3.03-17.82, P < 0.01). When stratified into tertiles, individuals in the highest tertile had a 57% higher likelihood of HI compared to the lowest tertile (Odds Ratio = 1.57, 95% Confidence Interval: 1.14-2.18, P < 0.01). RCS analysis indicated a significant non-linear association (P for non-linearity < 0.05) with an inflection point at a C-index of 1.17. Subgroup analysis revealed significant interaction effects of C-index with gender, diabetes and hypertension (P for interaction < 0.05) but not with age (P > 0.05).

Conclusion: Higher C-index values are independently associated with greater odds of HI. Given the rising burden of obesity and its metabolic consequences, the C-index may serve as a practical tool for HI risk assessment, especially in populations with cardiometabolic risk factors.

Keywords: Conicity index; NHANES; cross-sectional analysis; hearing impairment; obesity.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart of data enrolment in this study.
Figure 2
Figure 2
The correlation between HI and C-index.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Chadha S, Kamenov K, Cieza A. The world report on hearing, 2021. Bull World Health Organ. 2021;99((4)):242–242A. - PMC - PubMed
    1. Shen P, Hu D, Shen M, Du T, Zhao L, Han M, et al. Association of mixed polycyclic aromatic hydrocarbons exposure with hearing loss and the mediating role of blood cell markers of inflammation in U.S. adults. Front Public Health. 2024;12:1410601. - PMC - PubMed
    1. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1545–602. - PMC - PubMed
    1. Mayoral LP, Andrade GM, Mayoral EP, Huerta TH, Canseco SP, Rodal Canales FJ, et al. Obesity subtypes, related biomarkers & heterogeneity. Indian J Med Res. 2020;151:11–21. - PMC - PubMed
    1. Stadler JT, Marsche G. Obesity-related changes in high-density lipoprotein metabolism and function. Int J Mol Sci. 2020;21:8985. - PMC - PubMed

LinkOut - more resources