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Objective Metabolic syndrome is a risk factor for age-related hearing impairment ( ARHI). There are metabolic differences between abdominal adipose tissue present in subcutaneous and visceral areas. In this study, we investigated the association between abdominal fat composition, measured by computerized tomography ( CT), and hearing thresholds. Patients and Methods We recruited 662 adults aged 40-82 years with normal or symmetrical sensorineural hearing loss who underwent fat measurement by CT. Linear regression models were used to address the association between risk factors, including abdominal fat composition, and average hearing levels at low and high frequencies. Results After adjusting for age, systemic disease and other variables, a positive association between visceral adipose tissue ( VAT) area and average hearing threshold was observed in women. In men, there was no significant association between abdominal fat composition and hearing threshold. Conclusion Our findings show an association between VAT and hearing impairment in women. A reduction in visceral adiposity may help to prevent hearing loss in women. [ABSTRACT FROM AUTHOR]