Education degree predicts cardiovascular outcomes in men suffering from erectile dysfunction

Age disparity in couples and the sexual and general health of the male partner

INTRODUCTION

Several robust epidemiological studies suggest that men are often engaged in sexual relationships with younger women with a variable, age-dependent age difference. However, the ageing process determines a significant worsening of the andrological status, which favors the onset of erectile dysfunction and hypogonadism.

OBJECTIVES

To analyze the effects of differences in age between the partners [delta (Δ) age (M - F)] on patients referring to the Andrology Unit of Careggi University Hospital for male sexual dysfunction.

MATERIALS AND METHODS

A monocentre cohort of 4055 male subjects was evaluated by SIEDY structured interview. The cross-sectional analysis assessed the psychobiological and relational correlates. The rate of forthcoming major cardiovascular events (MACE) was investigated in the longitudinal analysis. All the models have been adjusted for age, education, lifestyle, and chronic disease score.

RESULTS

∆ age (M-F) shows a stepwise increase, according to the increasing age bands of the male partner. ∆ age (M-F) was associated with a greater number of children, at the cost of more conflictual relationships within the family. The phenotype of these relationships is characterized by the report of a partner with a higher sexual desire and a higher ability to reach climax. Men seeking a younger partner show more often a histrionic personality (p = 0.023) and higher testosterone levels (p = 0.032). However, having a younger partner doesn't improve the ability to obtain a full erection. Kaplan-Maier analysis of a longitudinal subgroup of patients followed longitudinally (N = 1402) for 4.3 ± 2,59 years, showed that patients in the fourth quartile had a higher rate of forthcoming MACE versus those in the first quartile (p = 0.005).

DISCUSSION AND CONCLUSION

In subjects with sexual dysfunctions (as in the general population) age-different relationships increase as a function of male ageing. A greater Δ age (M-F) is associated with specific men and relationship features and a higher risk of MACE.

Is 'living apart together' a real advantage for patients consulting for sexual dysfunction? A cohort study

BACKGROUND

Quantitative research on families has introduced a new category of relationship called living apart together, that is, when a couple in a committed relationship live in separate homes. This study aimed to confirm whether living apart together improves sexual relationships in those suffering from sexual dysfunction.

METHODS

This study comprised cross-sectional (N = 4852) and longitudinal (N = 1402) analyses. The former explored psychobiological, hormonal and relational correlates using the Structured Interview on Erectile Dysfunction scale. The latter assessed the occurrence of major adverse cardiovascular events in a subset of patients followed for 4.3 ± 2.59 years.

RESULTS

Compared to cohabiting couples, patients in living apart together relationships were younger and characterised by higher education levels, healthier lifestyles and lower comorbidity burdens (all p < 0.001). After adjusting for those confounders, the living apart together group reported better sexual functioning, more frequent sexual intercourse, and higher total testosterone levels (p < 0.001), and the relationship was often a source of conflicts within the familial context and of shorter duration (all p < 0.05). When total testosterone was included in a fully adjusted analysis of covariance, the difference in obtaining a full erection between cohabiting and living apart together relationships became non-significant (p = 0.086), suggesting a hormonal influence on erectile dysfunction. In the longitudinal analysis, Cox models adjusted for the aforementioned confounders showed that living apart together relationships are associated with a twofold greater risk of major adverse cardiovascular events than cohabiting relationships, independent of other risk factors, including total testosterone levels, waist circumference and pathological penile blood flow.

DISCUSSION

This study illustrates that partnership arrangements can shape sexual interest and complaints, as reported by the participants. While men involved in living apart together relationships show an ostensibly healthier phenotype, they experienced more often major adverse cardiovascular events. Therefore, co-residential relationship appears to provide more effective protection against future major adverse cardiovascular events for the male partner than a living apart together relationship.

The association between serum 25-hydroxyvitamin D levels and erectile dysfunction: a two-sample Mendelian randomization analysis

Considering that vascular endothelial cell dysfunction is the pathological basis of erectile dysfunction (ED), and recognizing the beneficial effects of 25-hydroxyvitamin D (25(OH)D) on vascular endothelial cell protection, the researchers diligently investigated the causal relationship between serum 25(OH)D levels and ED. However, inconsistent clinical evidence has left the association between serum 25(OH)D levels and ED unclear. The objective of this work was to employ Mendelian randomization (MR) analysis to ascertain the potential causal relationship between serum 25(OH)D levels and ED. We conducted a two-sample MR analysis utilizing data from publicly available genome-wide association studies (GWASs). The primary analysis method for the MR analysis was the inverse-variance weighted (IVW) method, supplemented by the MR-Egger and weighted median methods. In addition, we evaluated heterogeneity with Cochran's Q test, assessed pleiotropy using the MR-Egger intercept test, and performed a leave-one-out analysis to identify single-nucleotide polymorphisms (SNPs) with potential effects. Outliers were detected using MR-pleiotropy residual sum and outlier (MR-PRESSO). Genetically predicted serum 25(OH)D levels were not found to be causally associated with ED in IVW method (OR = 1.028, 95% CI = 0.845-1.250, P = 0.785), MR-Egger method (OR = 1.057, 95% CI = 0.782-1.430, P = 0.720), and weighted median method (OR = 1.225, 95% CI = 0.920-1.633, P = 0.165). The results of sensitivity analyses reinforced our conclusion, indicating no evidence of heterogeneity or directional pleiotropy. In summary, our findings do not substantiate a genetic-level causal link between serum 25(OH)D levels and the prevalence of ED. Nonetheless, future research, including larger MR studies, clinical trials, and additional observational studies, is essential to validate and reinforce the outcomes of our present study.

Investigating a novel surrogate indicator of adipose accumulation in relation to erectile dysfunction

INTRODUCTION

Although previous studies have linked obesity and erectile dysfunction, the novel surrogate indicators of adipose accumulation are more essential and dependable factors to consider. Therefore, the primary objective of the current investigation was to examine and clarify the association between metabolic score for visceral fat (METS-VF) and erectile dysfunction.

METHODS

Firstly, multivariate logistic regression analysis, smoothed curve fitting, and threshold effect analysis were employed to investigate the association between METS-VF and erectile dysfunction. Mediation analysis was also performed to evaluate the mediating role of homocysteine and inflammation. After that, subgroup analysis was carried out to examine the stability of the correlation of METS-VF with erectile dysfunction in various population settings. Furthermore, the area under the receiver operating characteristic (ROC) curve and eXtreme Gradient Boosting (XGBoost) algorithm were utilized to assess the capability of identifying METS-VF in comparison to the other four obesity-related indicators in identifying erectile dysfunction.

RESULTS

After adjusting for all confounding factors, METS-VF was strongly and favourablely correlated with erectile dysfunction. With each additional unit rise in METS-VF, the prevalence of erectile dysfunction increased by 141%. A J-shaped relationship between METS-VF and erectile dysfunction was discovered through smoothed curve fitting. Marital status, physical activity, and smoking status can potentially modify this association. This finding of the ROC curve suggests that METS-VF had a powerful identifying capacity for erectile dysfunction (AUC = 0.7351). Homocysteine and inflammation mediated 4.24% and 2.81%, respectively.

CONCLUSION

The findings of the current investigation suggest that METS-VF can be considered a dependable identifying indicator of erectile dysfunction.