{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T01:32:32Z","timestamp":1789090352839,"version":"build-2803163510"},"reference-count":42,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to determine whether haemoglobin A1c (HbA1c) level is associated with the incidence of hearing impairment accounting for smoking status and diabetic condition at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were 131\u2009689 men and 71\u2009286 women aged 30\u201365 years and free of hearing impairment at baseline (2008) who attended Japanese occupational annual health check-ups from 2008 to 2015. We defined low-frequency hearing impairment at a hearing threshold &gt;30\u2009dB at 1\u2009kHz and high frequency at &gt;40\u2009dB at 4\u2009kHz in the better ear in pure-tone audiometric tests. HbA1c was categorised into seven categories. The association between HbA1c and hearing impairment was assessed using the Cox proportional hazards model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On 5 years mean follow-up, high HbA1c was associated with high-frequency hearing impairment. In non-smokers, HbA1c\u22658.0% was associated with high-frequency hearing impairment, with a multivariable HR (95% CI) compared with HbA1c 5.0%\u20135.4% of 1.46 (1.10 to 1.94) in men and 2.15 (1.13 to 4.10) in women. There was no significant association between HbA1c and hearing impairment in smokers. A J-shaped association between HbA1c and high-frequency hearing impairment was observed for participants with diabetes at baseline. HbA1c was not associated with low-frequency hearing impairment among any participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HbA1c \u22658.0% of non-smokers and \u22657.3% of participants with diabetes was associated with high-frequency hearing impairment. These findings indicate that appropriate glycaemic control may prevent diabetic-related hearing impairment.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-023220","type":"journal-article","created":{"date-parts":[[2018,9,17]],"date-time":"2018-09-17T14:46:10Z","timestamp":1537195570000},"page":"e023220","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Haemoglobin A1c and hearing impairment: longitudinal analysis using a large occupational health check-up data of Japan"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5879-9650","authenticated-orcid":false,"given":"Satsue","family":"Nagahama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikuko","family":"Kashino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Nanri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayo","family":"Kurotani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kuwahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Dan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Michikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamima","family":"Akter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Mizoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Murakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Nishiwaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,9,17]]},"reference":[{"key":"2020050713401688000_8.9.e023220.1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.362"},{"key":"2020050713401688000_8.9.e023220.2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.42"},{"key":"2020050713401688000_8.9.e023220.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.281.6245.903"},{"key":"2020050713401688000_8.9.e023220.4"},{"key":"2020050713401688000_8.9.e023220.5","unstructured":"WHO. 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