Association between sarcopenia and erectile dysfunction in older males

Development and validation of a prediction model for ED using machine learning: according to NHANES 2001-2004

Erectile Dysfunction (ED) is a form of sexual dysfunction in males that imposes significant health and financial burdens globally. Despite its high prevalence, diagnosing ED remains challenging due to the limitations of current diagnostic methods and patients' reluctance to seek medical help. Currently, some studies have used machine learning techniques for developing ED prediction models, but the performance and interpretability of existing models need to be further improved. This study utilized data from the National Health and Nutrition Examination Survey (NHANES) for the years 2001 to 2004, adhering to the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) statement. After excluding male respondents who did not meet the study criteria, a total of 3,869 participants were included. Gradient boosting decision tree (GBDT) algorithms (XGBoost, CatBoost, LightGBM) were used to develop the ED prediction model. Data preprocessing, feature selection, model evaluation, and interpretability analysis were performed to ensure the reliability and effectiveness of the model. The model evaluation results revealed that the AUC values are XGBoost: 0.887 ± 0.016; LightGBM: 0.879 ± 0.016; CatBoost: 0.871 ± 0.019. The F1-Scores are XGBoost: 0.695 ± 0.023; LightGBM: 0.681 ± 0.025; CatBoost: 0.681 ± 0.025. The Recall values are XGBoost: 0.789 ± 0.026; LightGBM: 0.739 ± 0.030; CatBoost: 0.711 ± 0.030. These results confirmed that the XGBoost model is the best-performing ED prediction model in this study. Interpretability analysis results of the XGBoost model showed that age, obesity, cardiovascular risk factors, prostate-related diseases, and socioeconomic status are key features for predicting ED, playing a significant role in the ED mechanism. Therefore, we believe the ED prediction model trained in this study has strong predictive performance and high interpretability. This model can help to expand the diagnostic options for ED, improve the diagnosis rate of ED, and assist doctors in early intervention for patients with ED, ultimately improving patient prognosis.

Is erectile dysfunction associated with osteoarthritis and rheumatoid arthritis? Insights from a population-based study

BACKGROUND

The correlation between osteoarthritis (OA) and rheumatoid arthritis (RA), both significant components of arthritis, and erectile dysfunction (ED) has yet to be thoroughly investigated.

AIM

In this study we aimed to assess the association of OA and RA with ED.

METHODS

In this observational study we used data from the National Health and Nutrition Examination Survey, which was conducted between 2001 and 2004. Various statistical analyses were employed to investigate the associations of OA and RA with ED, including multivariable logistic regression analysis and subgroup analysis.

OUTCOMES

The primary outcome for this investigation was arthritis as assessed through self-reporting.

RESULTS

In this comprehensive nationally representative survey spanning 4 years, our findings revealed a notably elevated incidence of ED within both OA and RA populations in comparison to the general population. Additional research is imperative to provide a deeper understanding of these correlations and their potential implications for both pathogenesis and treatment strategies.

CLINICAL IMPLICATIONS

The research outcomes reported here may serve as a valuable guide for clinicians to assist OA and RA patientsin staying vigilant in addressing their sexual health concerns.

STRENGTHS AND LIMITATIONS

We explored the association of OA and RA with ED. However, this is only a cross-sectional study.

CONCLUSION

In this comprehensive nationally representative survey spanning 4 years, our findings revealed a notably elevated incidence of ED within both OA and RA patient populations in comparison to the general population. Ongoing research is imperative to provide a deeper understanding of these correlations.

Muscle Strength and Male Sexual Function

Sexual dysfunction, in particular erectile dysfunction, is a common complaint among aging men. Obesity, diabetes, hypertension, and smoking are shown to be independent risk factors for erectile dysfunction, while cardiorespiratory fitness is shown to be protective. Less is known about the role of muscle strength in male sexual function. Our objective was to study the association between male sexual function and typical cardiovascular risk factors, together with exercise and muscle strength. We included data from the fourth wave of the RHINE study. Data on anthropometrics, exercise habits, diseases, muscle strength, and sexual function were collected using questionnaires, including the Aging Males' Symptoms (AMS) scale. We used multivariable logistic regression analysis to measure the association between sexual function and body mass index (BMI), age, smoking, diabetes, hypertension, exercise and muscle strength status. We included 2116 men aged 48-75 from four Nordic-Baltic countries. BMI, age, smoking, diabetes, and hypertension were found to be associated with higher odds of reporting decreased sexual function, while reporting intact muscle strength was associated with lower odds. In a large Nordic-Baltic male study population, we show that known cardiovascular risk factors are associated with decreased sexual function, while reporting intact muscle strength is associated with lower odds of reporting decreased sexual function.

Sarcopenic obesity is not associated with sexual dysfunction in older adults: a cross-sectional study

BACKGROUND

This study aimed to investigate the frequency of sexual dysfunction (SD) and the association between SD and body composition abnormalities, such as sarcopenia, obesity, and sarcopenic obesity.

METHODS

Older adults (≥65 years) were included. Sarcopenic obesity was diagnosed by using newly defined ESPEN-EASO diagram. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People criteria. Obesity was defined using the fat percentile cut-offs suggested by ESPEN-EASO. SD was determined by Arizona Sexual Experience Scale (ASEX).

RESULTS

Two-hundred and sixty-seven volunteers (64.4% female, mean age 73.63 ± 6.22 years) participated in this study. One-hundred seventy-eight individuals (66.7%) had SD. It was present in 83.1% and 36.8% of the females and males, respectively (p < 0.0001). There was no association between SD and sarcopenia alone (OR: 1.359, 95% CI: 0.650-2.838, p = 0.415) or obesity alone (OR: 0.986, 95% CI: 0.543-1.791, p = 0.963). Sarcopenic obesity was significantly associated with SD (OR: 9.116, 95% CI: 1.173-70.851, p = 0.035). However, this significance was lost after the model was adjusted for gender, marital status, and comorbidities (OR: 4.676, 95% CI: 0.578-37.801, p = 0.148).

CONCLUSIONS

SD was present in 66.7% of the older adults and was not associated with sarcopenia, obesity, or sarcopenic obesity. Further longitudinal studies are needed on this topic.