Blood levels of nicotinic acid negatively correlate with hearing ability in healthy older men

Background: Age-related hearing loss (ARHL) is a common phenomenon observed during aging. On the other hand, the decrease in Nicotinamide adenine dinucleotide (NAD +) levels is reported to be closely related to the age-related declines in physiological functions such as ARHL in animal studies. Moreover, preclinical studies confirmed NAD + replenishment effectively prevents the onset of age-related diseases. However, there is a paucity of studies on the relationship between NAD⁺ metabolism and ARHL in humans. Methods: This study was analyzed the baseline results of our previous clinical trial, in which nicotinamide mononucleotide or placebo was administered to 42 older men (Igarashi et al., NPJ Aging 8:5, 2022). The correlations between blood levels of NAD⁺-related metabolites at baseline and pure-tone hearing thresholds at different frequencies (125, 250, 500, 1000, 2000, 4000, and 8000 Hz) in 42 healthy Japanese men aged > 65 years were analyzed using Spearman’s rank correlation. Multiple linear regression analysis was performed with hearing thresholds as the dependent variable and age and NAD⁺-related metabolite levels as independent variables. Results: Positive associations were observed between levels of nicotinic acid (NA, a NAD⁺ precursor in the Preiss-Handler pathway) and right- or left-ear hearing thresholds at frequencies of 1000 Hz (right: r = 0.480, p = 0.001; left: r = 0.422, p = 0.003), 2000 Hz (right: r = 0.507, p < 0.001, left: r = 0.629, p < 0.001), and 4000 Hz (left: r = 0.366, p = 0.029). Age-adjusted multiple linear regression analysis revealed that NA was an independent predictor of elevated hearing thresholds (1000 Hz (right): p = 0.050, regression coefficient (β) = 1610; 1000 Hz (left): p = 0.026, β = 2179; 2000 Hz (right): p = 0.022, β = 2317; 2000 Hz (left): p = 0.002, β = 3257). Weak associations of nicotinic acid riboside (NAR) and nicotinamide (NAM) with hearing ability were observed. Conclusions: We identified negative correlations between blood concentrations of NA and hearing ability at 1000 and 2000 Hz. NAD⁺ metabolic pathway might be associated with ARHL onset or progression. Further studies are warranted. Trial registration: The study was registered at UMIN-CTR (UMIN000036321) on 1st June 2019. Graphical Abstract: [Figure not available: see fulltext.]