(812) Associations of Autoimmune Diseases with Hearing Loss - an All of Us Analysis

Introduction: Autoimmune disease has been implicated in inner ear injury, but phenotype-specific associations with HL remain unclear. Associations between autoimmune disease and sensorineural (SNHL) and mixed HL were evaluated.

Methods: The NIH All of Us Program was queried for HL and autoimmune disease. Patients with HL were matched to non-HL controls via PSM. Multivariable logistic regression estimated adjusted odds ratios (aORs) adjusting for age, sex, race, ethnicity, and co-occurring autoimmune diseases.

Results: Among 165,785 participants, 6,553 had mixed HL, and 30,437 had SNHL. The cohort was predominantly female (60.9%), White (55.0%), and non-Hispanic (79.0%), with a median age in the mid-50s (IQR: 38–67). The most common autoimmune disease associated with SNHL was Rheumatoid Arthritis [aOR: 1.54 (95% CI 1.45-1.64), p<.001], followed by Sjögren’s syndrome [1.75 (1.62-1.90), p<.001], Systemic Lupus Erythematosus [aOR:1.35 (1.21-1.51), p< 0.001], Sarcoidosis [1.84 (1.63-2.07), p<.001], Multiple Sclerosis [1.60 (1.43-1.79), p<.001], and systemic vasculitides (Behcet’s, GPA, and Polyarteritis Nodosa) [1.84 (1.43-2.35),p <.001]. Systemic Sclerosis and antiphospholipid syndrome were not significant.

The most common autoimmune disease associated with mixed HL was Rheumatoid Arthritis [1.72 (1.54-1.92), p< 0.001], followed by Sjögren’s Syndrome [1.91 (1.65-2.20), p<.001], Systemic Lupus Erythematosus [1.27 (1.04-1.54), p=0.016], Sarcoidosis [1.59 (1.25-1.99), p<.001], Multiple Sclerosis [1.39 (1.10–1.73), Antiphospholipid Syndrome [1.67 (1.20-2.26), p<.001], p=0.004), Systemic Sclerosis [1.55 (1.12-2.09), p=0.006], and systemic vasculitis [4.88 (3.57-6.55), p<.001].

Conclusions: Multiple autoimmune diseases were independently associated with higher odds of both SNHL and mixed HL, supporting an immune-mediated contribution to inner ear injury and the need for targeted screening.