Investigating the association between triglyceride glucose–body mass index and hearing loss: Results from the NHANES 2001–2012 and 2015–2018

This study aims to explore the association of the triglyceride glucose-body mass index (TyG-BMI) with hearing loss (HL) in a nationally representative cohort. A total of 6558 participants from the National Health and Nutrition Examination Survey (NHANES) cycles (2001-2012 and 2015-2018) were included. Multivariate logistic regression, generalized additive models, threshold-effect analyses, and subgroup analyses were utilized to evaluate the relationship between TyG-BMI and HL risk. The highest TyG-BMI quartile (Q4) exhibited 35% increased odds of overall HL (odds ratio [OR] = 1.35, 95% confidence interval: 1.10-1.65) and 34% higher risk of high-frequency hearing loss (HFHL; OR = 1.34, 95% confidence interval: 1.09-1.65) compared with the lowest quartile (Q1; P for trend < .05). No significant association was observed for low-frequency HL. A nonlinear dose-response relationship for HFHL revealed a critical threshold at TyG-BMI = 184.5 (P < .001). Subgroup analyses identified elevated HL risk in males (OR = 1.40), individuals aged <60 years (OR = 1.34), and those with diabetes (OR = 1.78). These findings suggest TyG-BMI as a potential indicator for HFHL. Maintaining TyG-BMI below 184.5 may improve HFHL management outcomes. The observed nonlinear relationship suggests potential metabolic thresholds that need confirmation from longitudinal studies. Future studies should validate these thresholds in diverse populations and explore clinical integration for early screening.