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Original Investigation
December 29, 2016

Association of Iron Deficiency Anemia With Hearing Loss in US Adults

Author Affiliations
  • 1Doctoral student, Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey
  • 2Department of Medicine, Pennsylvania State University College of Medicine, Hershey
  • 3Department of Neurosurgery, Pennsylvania State University College of Medicine, Hershey
  • 4Department of Kinesiology, Noll Laboratory, Pennsylvania State University, State College
  • 5Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey
JAMA Otolaryngol Head Neck Surg. Published online December 29, 2016. doi:10.1001/jamaoto.2016.3631
Key Points

Question  Is iron deficiency anemia associated with hearing loss in the adult population?

Findings  In this retrospective cohort study of 305 339 young to elderly adults, iron deficiency anemia was positively associated with sensorineural hearing loss and the presence of combined hearing loss.

Meaning  Additional studies to examine how iron supplementation influences hearing status are warranted.


Importance  Hearing loss in the US adult population is linked to hospitalization, poorer self-reported health, hypertension, diabetes, and tobacco use. Because iron deficiency anemia (IDA) is a common and easily correctable condition, further understanding of the association between IDA and all types of hearing loss in a population of US adults may help to open new possibilities for early identification and appropriate treatment.

Objective  To evaluate the association between sensorineural hearing loss (SNHL) and conductive hearing loss and IDA in adults aged 21 to 90 years in the United States.

Design, Setting, and Participants  The prevalence of IDA and hearing loss (International Classification of Diseases, Ninth Revision codes 389.1 [SNHL], 389.0 [conductive hearing loss], and 389 [combined hearing loss]) was identified in this retrospective cohort study at the Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Iron deficiency anemia was determined by low hemoglobin and ferritin levels for age and sex in 305 339 adults aged 21 to 90 years. Associations between hearing loss and IDA were evaluated using χ2 testing, and logistic regression was used to model the risk of hearing loss among those with IDA. The study was conducted from January 1, 2011, to October 1, 2015.

Main Outcomes and Measures  Hearing loss.

Results  Of 305 339 patients in the study population, 132 551 were men (43.4%); mean (SD) age was 50.1 (18.5) years. There was a 1.6% (n = 4807) prevalence of combined hearing loss and 0.7% (n = 2274) prevalence of IDA. Both SNHL (present in 26 of 2274 individuals [1.1%] with IDA; P = .005) and combined hearing loss (present in 77 [3.4%]; P < .001) were significantly associated with IDA. Logistic regression analysis confirmed increased odds of SNHL (adjusted odds ratio [OR], 1.82; 95% CI, 1.18-2.66) and combined hearing loss (adjusted OR, 2.41; 95% CI, 1.90-3.01) among adults with IDA, after adjusting for sex.

Conclusions and Relevance  Iron deficiency anemia was associated with SNHL and combined hearing loss in a population of adult patients. Further research is needed to better understand the potential links between IDA and hearing loss and whether screening and treatment of IDA in adults could have clinical implications in patients with hearing loss.