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Liu YF, Wang HH, Geng YH, Han L, Tu SH, Chen JS, Wen CY. Uncovering the Potential Mechanisms and Effects of Hyperuricemia and its Associated Diseases on Male Reproduction. Reprod Sci 2024:10.1007/s43032-024-01453-7. [PMID: 38379071 DOI: 10.1007/s43032-024-01453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/03/2024] [Indexed: 02/22/2024]
Abstract
Male fertility and metabolic disorders, including obesity and diabetes, are closely connected. Since hyperuricemia and metabolic syndrome are strongly related, male fertility and hyperuricemia may, to some degree, be associated. According to recent studies, hyperuricemia imposes various effects on sex hormones, semen quality, and male erectile dysfunction. Some researchers claim that uric acid worsens male semen and raises the risk of erectile dysfunction (ED), while others state that it safeguards both penile erection and male semen. Additionally, it has been shown that gout and metabolic syndrome also raise the risk of ED. To clarify this controversy, the influence and potential mechanisms of hyperuricemia on ED, semen quality, sex hormone levels, and the effects of hyperuricemia-related disorders on ED will be comprehensively summarized.
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Affiliation(s)
- Ya-Fei Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Huan-Huan Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yin-Hong Geng
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liang Han
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng-Hao Tu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-She Chen
- The Reproduction Center, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou, China
| | - Cai-Yuzhu Wen
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Huang L, Liu H, Li L, Wang S, Sun G. Correlation between visceral fat metabolism score and erectile dysfunction: a cross-sectional study from NHANES 2001-2004. Front Endocrinol (Lausanne) 2023; 14:1283545. [PMID: 38125791 PMCID: PMC10732023 DOI: 10.3389/fendo.2023.1283545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
Backgrounds The factors associated with erectile dysfunction (ED) are diverse, and obesity is a significant component. Metabolic Score for Visceral Fat (METS-VF) can assess obesity more accurately than body mass index (BMI). However, the association between METS-VF and ED remains unclear. Objective This study aimed to investigate the association between the METS-VF and ED using National Health and Nutrition Examination Survey (NHANES) 2001-2004 data. Methods Data were sourced from NHANES 2001-2004. The relationship between METS-VF and ED was analyzed using multivariate logistic regression, followed by subgroup analyses to identify sensitive populations. Nonlinear correlation was evaluated through smoothed curve fitting, and a threshold effect analysis validated the findings. Comparative logistic regression of the Receiver Operating Characteristic (ROC) curve assessed the diagnostic capability of METS-VF against the classical obesity index for ED. Results The study enrolled 3625 participants, of whom 961 self-reported ED history and 360 reported severe ED. After adjusting for confounders, METS-VF exhibited a positive association with asthma prevalence (OR= 3.47, 95% CI: 2.83, 14.24). Stratification based on median METS-VF revealed higher ED prevalence in participants with elevated METS-VF (OR= 2.81,95% CI:2.32, 3.41). Nonlinear correlation was observed, with a significant association between METS-VF and ED when METS-VF exceeded 6.63. Subgroup analysis highlighted a stronger correlation in participants aged 50-85 years, Caucasians, hypertensive individuals, diabetics, and those with coronary heart disease. Sensitivity analysis using severe ED as the outcome reaffirmed the nonlinear positive association with METS-VF (OR=3.86, 95% CI:2.80,5.33), particularly when METS-VF surpassed 6.68. Conclusion Elevated METS-VF was nonlinearly correlated with increased ED incidence. Individuals with METS-VF above 6.63 should be vigilant about heightened ED risk. Special attention should be given to participants aged 50-85 years, Caucasians, hypertensive individuals, diabetics, and those with coronary heart disease.
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Affiliation(s)
- Lewei Huang
- General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Heqian Liu
- Wuhu Hospital, East China Normal University (The Second People’s Hospital of Wuhu), Wuhu, Anhui, China
| | - Lianqiang Li
- General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Shudong Wang
- General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Gang Sun
- General Hospital of Northern Theater Command, Shenyang, Liaoning, China
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Madani AH, Akhavan A, Madani MH, Farah AS, Esmaeili S, Maroufizadeh S, Zavarmousavi SM, Ziaeefar P, Rouientan H, Narouie B. Evaluation of the frequency of metabolic syndrome and assessment of cardiometabolic index among men with erectile dysfunction: a prospective cross-sectional study. J Diabetes Metab Disord 2023; 22:1191-1196. [PMID: 37975074 PMCID: PMC10638291 DOI: 10.1007/s40200-023-01231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/28/2023] [Indexed: 11/19/2023]
Abstract
Purpose Recently, an association has been observed between metabolic syndrome and erectile dysfunction (ED). This study aimed to evaluate the cardiometabolic index (CMI) in patients with ED. Methods This cross-sectional study was performed on 144 patients with ED who were referred to a urology clinic in Rasht, Iran, from 2019 to 2021. Metabolic syndrome was evaluated according to National Cholesterol Education Program Expert Panel (NCEP) and Adult Treatment Panel III (ATP III) criteria which are considered three positive criteria from five. Also, the ED severity was classified as weak, moderate, and severe based on the five-item International Index of Erectile Function (IIEF5) questionnaire. Results The mean age of participants was 53.46 ± 10.58 years. 56.9% had abdominal obesity, 48.6% had hypertriglyceridemia, 34.7% had low HDL-C, 55.6% had hypertension and 56.9% had elevated fasting blood sugar (FBS). 43.8% had diabetes and 13.2% had cardiovascular disease. The mean CMI was 2.51 ± 1.57. The prevalence of metabolic syndrome was 50.7%. Body mass index (BMI) was significantly associated with metabolic syndrome and CMI (P = 0.001). The severity of ED had a significant relationship with high FBS in patients. CMI and components of abdominal obesity, hypertriglyceridemia, and low HDL-C had no statistically significant relationship with ED. However, the incidence of moderate and severe ED increased with increasing the number of metabolic syndrome components. Conclusion ED is not significantly associated with metabolic syndrome and CMI, however, the severity of this disorder increases with increasing the number of components of metabolic syndrome.
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Affiliation(s)
- Ali Hamidi Madani
- Urology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, 009843 Iran
| | - Ardalan Akhavan
- Urology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, 009843 Iran
| | - Mohammad Hamidi Madani
- Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, 009821 Iran
| | - Ali Sadeghi Farah
- Urology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, 009843 Iran
| | - Samaneh Esmaeili
- Urology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, 009843 Iran
| | - Saman Maroufizadeh
- Department of Biostatistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, 009843 Iran
| | - Seyedeh Maryam Zavarmousavi
- Department of Psychiatry, School of Medicine, Shafa Hospital, Guilan University of Medical Sciences, Rasht, 009843 Iran
| | - Pardis Ziaeefar
- Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, 009821 Iran
| | - Hamidreza Rouientan
- Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, 009821 Iran
| | - Behzad Narouie
- Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, 009821 Iran
- Department of Urology, Zahedan University of Medical Sciences, Zahedan, 009854 Iran
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Corona DG, Vena W, Pizzocaro A, Rastrelli G, Sparano C, Sforza A, Vignozzi L, Maggi M. Metabolic syndrome and erectile dysfunction: a systematic review and meta-analysis study. J Endocrinol Invest 2023; 46:2195-2211. [PMID: 37515706 DOI: 10.1007/s40618-023-02136-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/09/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE The clinical significance of metabolic syndrome (MetS) versus its single components in erectile dysfunction (ED) is conflicting. Thus, the purpose is to analyze the available evidence on the relationship between MetS-along with its components-and ED. METHODS All prospective and retrospective observational studies reporting information on ED and MetS were included. In addition, we here reanalyzed preclinical and clinical data obtained from a previously published animal model of MetS and from a consecutive series of more than 2697 men (mean age: 52.7 ± 12), respectively. RESULTS Data derived from this meta-analysis showed that MetS was associated with an up to fourfold increased risk of ED when either unadjusted or adjusted data were considered. Meta-regression analysis, performed using unadjusted statistics, showed that the MetS-related risk of ED was closely associated with all the MetS components. These associations were confirmed when unadjusted analyses from clinical models were considered. However, fully adjusted data showed that MetS-associated ED was more often due to morbidities included (or not) in the algorithm than to the MetS diagnostic category itself. MetS is also associated with low testosterone, but its contribution to MetS-associated ED-as derived from preclinical and clinical models-although independent, is marginal. CONCLUSIONS The results of our analysis suggest that MetS is a useless diagnostic category for studying ED. However, treating the individual MetS components is important, because they play a pivotal role in determining ED.
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Affiliation(s)
- D G Corona
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy.
| | - W Vena
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Pizzocaro
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - C Sparano
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - A Sforza
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - M Maggi
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Katsimardou A, Patoulias D, Zografou I, Siskos F, Stavropoulos K, Imprialos K, Tegou Z, Boulmpou A, Georgopoulou V, Hatzipapa N, Papadopoulos C, Doumas M. The Impact of Metabolic Syndrome Components on Erectile Function in Patients with Type 2 Diabetes. Metabolites 2023; 13:metabo13050617. [PMID: 37233658 DOI: 10.3390/metabo13050617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 03/31/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
Erectile dysfunction is commonly encountered in diabetic patients and in patients with metabolic syndrome; however, only a few studies have assessed patients with metabolic syndrome and type 2 diabetes mellitus (T2DM) regarding their sexual function. The purpose of this study is to examine the effect of metabolic syndrome and its components on the erectile function of T2DM patients. A cross-sectional study including T2DM patients was conducted from November 2018 until November 2020. Participants were evaluated for the presence of metabolic syndrome and their sexual function was assessed using the International Index of Erectile Function (IIEF) questionnaire. A total of 45 consecutive male patients participated in this study. Metabolic syndrome was diagnosed in 84.4% and erectile dysfunction (ED) in 86.7% of them. Metabolic syndrome was not associated with ED or ED severity. Among metabolic syndrome components, only high-density lipoprotein cholesterol (HDL) was associated with ED [x2 (1, n = 45) = 3.894, p = 0.048; OR = 5.5 (95% CI: 0.890-33.99)] and with the IIEF erectile function scores (median 23 vs. 18, U = 75, p = 0.012). Multiple regression analyses showed that HDL was non-significantly associated with the IIEF erectile function scores. In conclusion, among T2DM patients HDL is associated with ED.
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Affiliation(s)
- Alexandra Katsimardou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Dimitrios Patoulias
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Ioanna Zografou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Fotios Siskos
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Konstantinos Stavropoulos
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Konstantinos Imprialos
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Zoi Tegou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Aristi Boulmpou
- 3rd Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Vivian Georgopoulou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Nikoleta Hatzipapa
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Christodoulos Papadopoulos
- 3rd Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Michael Doumas
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
- Veterans Affairs Medical Center, George Washington University, Washington, DC 20422, USA
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Abstract
: Sexual health is an integral part of overall health, and an active and healthy sexual life is an essential aspect of a good life quality. Cardiovascular disease and sexual health share common risk factors (arterial hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking) and common mediating mechanisms (endothelial dysfunction, subclinical inflammation, and atherosclerosis). This generated a shift of thinking about the pathophysiology and subsequently the management of sexual dysfunction. The introduction of phosphodiesterase type 5 inhibitors revolutionized the management of sexual dysfunction in men. This article will focus on erectile dysfunction and its association with arterial hypertension. This update of the position paper was created by the Working Group on Sexual Dysfunction and Arterial Hypertension of the European Society of Hypertension. This working group has been very active during the last years in promoting the familiarization of hypertension specialists and related physicians with erectile dysfunction, through numerous lectures in national and international meetings, a position paper, newsletters, guidelines, and a book specifically addressing erectile dysfunction in hypertensive patients. It was noted that erectile dysfunction precedes the development of coronary artery disease. The artery size hypothesis has been proposed as a potential explanation for this observation. This hypothesis seeks to explain the differing manifestation of the same vascular condition, based on the size of the vessels. Clinical presentations of the atherosclerotic and/or endothelium disease in the penile arteries might precede the corresponding manifestations from larger arteries. Treated hypertensive patients are more likely to have sexual dysfunction compared with untreated ones, suggesting a detrimental role of antihypertensive treatment on erectile function. The occurrence of erectile dysfunction seems to be related to undesirable effects of antihypertensive drugs on the penile tissue. Available information points toward divergent effects of antihypertensive drugs on erectile function, with diuretics and beta-blockers possessing the worst profile and angiotensin receptor blockers and nebivolol the best profile.
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Abstract
Objectives: Determination of the potential effect of metabolic syndrome (MetS) on erectile function in Egyptian men and description of the sociodemographic characteristics of these men.Materials and methods: A cohort of 615 patients presenting to urology department aged between 30 and 75 years were prospectively assessed and divided into two groups. Group I (n = 325) diagnosed with MetS and mean age of 56.07 ± 8.51 years. Group II (n = 290) subjects with no MetS and mean age 54.97 ± 8.14 years. Patients filled the IIEF questionnaire, medical, personal history, and BMI data were tabulated. Metabolic syndrome was determined when three or more of the five risk factors were present according to the NCEP.Results: In Group I (79.4%) of the patients had erectile dysfunction (ED). Of these, 20.3% had mild, 22.5% had moderate, and 36.6% had severe ED and 30% of patients without MetS had ED. Of these, 17.2% had mild, 5.9% had moderate, and 6.9% had severe ED (p < .001; odds ratio 5.549; 95% CI 3.101-9.928). Patients with metabolic syndrome had lower IIEF-EF domain scores. Logistic regression analysis revealed that DM, dyslipidemia, age, and HTN were the most important criteria for ED in the MetS group (p < .01). While in the group without MetS, DM, HTN, HDL, and age were the most important risk factors (p < .01), and TG and BMI were less important.Conclusions: MetS is a potential risk factor for ED in Egyptian men. Patients with MetS should be questioned about ED. The diabetic patients are most risky for ED.
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Affiliation(s)
- Mohammed Nader Salama
- Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Ahmed Abulfotooh Eid
- Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Alaa Hatem
- Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Ahmed Kamal Swidan
- Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
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Kara E, Kahraman E, Dayar E, Yetik Anacak G, Demir O, Gidener S, Atabey N, Durmus N. The role of resistin on metabolic syndrome-induced erectile dysfunction and the possible therapeutic effect of Boldine. Andrology 2020; 8:1728-1735. [PMID: 32609430 DOI: 10.1111/andr.12853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/02/2020] [Accepted: 06/24/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Resistin is known as a potential mediator of obesity-associated insulin resistance. The high resistin level disrupts nitric oxide (NO)-mediated relaxation which is also important in erectile function. An antioxidant alkaloid, Boldine, is known as anti-diabetic and protects endothelial functions. OBJECTIVES We aimed to investigate resistin expression in penile tissue in the presence of insulin resistance (IR) and the effect of Boldine treatment on erectile functions in the metabolic syndrome (MetS) rat model. MATERIALS AND METHODS Wistar rats were randomly divided into three groups: Control, MetS, and boldine treated MetS group. MetS parameters were assessed by serum triglycerides (TG), uric acid (UA), glucose, insulin levels, HOMA index, and waist circumference (WC)/tibia length (TL) ratio. To evaluate erectile functions, intracavernous pressure (ICP)/mean arterial pressure (MAP) ratio was performed during cavernous nerve stimulation. Protein expressions of resistin, endothelial nitric oxide synthase (eNOS), p(S1177) eNOS, and insulin receptor-β were evaluated by Western blotting. RESULTS TG, glucose, insulin levels, weight, WC/TL ratio, HOMA index and resistin expression in penile tissue were significantly increased and ICP/MAP values, and p (S1177) eNOS expression in penile tissue were decreased in MetS group. Boldine treatment enhanced ICP/MAP values, insulin receptor-β and p(S1177) eNOS expressions compared with the MetS group. DISCUSSION AND CONCLUSION MetS caused a deterioration in erectile function accompanied by an increase in resistin expression and a reduction in eNOS enzyme activation in the rat penile tissues. Boldine treatment resulted in an improvement in erectile function, independent of resistin expression.
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Affiliation(s)
- Erkan Kara
- Department of Pharmacology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Ezgi Dayar
- Department of Pharmacology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Gunay Yetik Anacak
- Department of Pharmacology, Faculty of Parmacy, Ege University, Izmir, Turkey
| | - Omer Demir
- Department of Urology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Sedef Gidener
- Department of Pharmacology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Nese Atabey
- Izmir Biomedicine and Genome Center, Izmir, Turkey
| | - Nergiz Durmus
- Department of Pharmacology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Moura A, Tomada I, Tomada N. The influence of metabolic profile of obese men on the severity of erectile dysfunction: are metabolically healthy obese individuals protected? Turk J Urol 2018; 44:455-461. [PMID: 30201077 DOI: 10.5152/tud.2018.66281] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 04/19/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine the prevalence of erectile dysfunction (ED) in metabolically healthy obese (MHO) individuals, and to compare ED severity and hypogonadism prevalence in MHO, metabolically unhealthy obese (MUO) and metabolically healthy non-obese individuals. MATERIAL AND METHODS ED patients (n=460) were evaluated by standardized protocol, that included clinical evaluation, abridged 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire survey, and Penile Duplex Doppler Ultrasound (PDDU) exam. Patients were classified as obese [body mass index (BMI) ≥30.0 kg/m2] and non-obese (BMI <30.0 kg/m2), and metabolic health status was defined by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. Statistical analysis was performed and statistical significance was considered at p-level <0.05. RESULTS The mean age of the subjects was 56.2±10.5 years. MHO was present in 40% of obese individuals (n=37). MUO had lower mean peak systolic velocity (mPSV) compared to MHO (28.1 cm/s vs. 36.9 cm/s; p=0.005), and IIEF-5 scores were also lower in MUO compared to MHO patients (10.2 vs. 13.1; p=0.018). No statistical differences in IIEF-5 score, mPSV and hypogonadism prevalence between MHO and metabolically healthy non-obese (MHNO) patients were observed. CONCLUSION Our results lead us to conclude that healthy metabolic profile protects obese individuals from severity of ED. The strong association between obesity and ED may be otherwise attributed to metabolic abnormalities present in the obese.
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Affiliation(s)
- Adriana Moura
- Faculty of Medicine of Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Inês Tomada
- Faculty of Biotechnology of Portuguese Catholic University and CBQF/Centro de Biotecnologia e Química Fina, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Arquiteto Lobão Vital, Porto, Portugal
| | - Nuno Tomada
- Department of Urology, Hospital da Luz, Praceta Henrique Moreira 150, 4400-346 Vila Nova de Gaia, Portugal; Instituto de Investigação e Inovação em Saúde (I3S), Rua Alfredo Allen 208, Porto, Portugal
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Bungum AB, Glazer CH, Bonde JP, Nilsson PM, Giwercman A, Søgaard Tøttenborg S. Risk of metabolic disorders in childless men: a population-based cohort study. BMJ Open 2018; 8:e020293. [PMID: 30121591 PMCID: PMC6104745 DOI: 10.1136/bmjopen-2017-020293] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To study whether male childlessness is associated with an increased risk of metabolic disorders such as metabolic syndrome (MetS) and diabetes. DESIGN A population-based cohort study. SETTING Not applicable. PARTICIPANTS 2572 men from the population-based Malmö Diet and Cancer Cardiovascular Cohort. INTERVENTIONS None. MAIN OUTCOME MEASURES From cross-sectional analyses, main outcome measures were ORs and 95% CIs for MetS and diabetes among childless men. In prospective analyses, HRs and 95% CI for diabetes among childless men. RESULTS At baseline, in men with a mean age of 57 years, the prevalence of MetS was 26% and 22% among childless men and fathers, respectively. Similarly, we observed a higher prevalence of diabetes of 11% among childless men compared with 5% among fathers. In the cross-sectional adjusted analyses, childless men had a higher risk of MetS and diabetes, with ORs of 1.22 (95% CI 0.87 to 1.72) and 2.12 (95% CI 1.34 to 3.36) compared with fathers. In the prospective analysis, during a mean follow-up of 18.3 years, we did not see any increase in diabetes risk among childless men (HR 1.02 (0.76 to 1.37)). CONCLUSION This study provides evidence of an association between male childlessness and a higher risk of MetS and diabetes. However, as these associations were found in cross-sectional analyses, reverse causation cannot be excluded.
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Affiliation(s)
- Ane Berger Bungum
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Kobenhavn, Denmark
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Kobenhavn, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Kobenhavn, Denmark
| | - Peter M Nilsson
- Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Kobenhavn, Denmark
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Abstract
This prospective study aimed to investigate the relationship between metabolic syndrome (Met S) and premature ejaculation (PE) among men. The study included 300 consecutive male patients (53.6 y ± 8.7) who attended the urology clinic (December 2013-September 2014), mostly complaining of renal/ureteric calculi. A diagnostic approach was undertaken to include demographics, clinical features and laboratory investigations of the study subjects. Both erectile function and PE were evaluated using the International Index of Erectile Function (abridged form, IIEF-5) and Premature Ejaculation Diagnostic Tool (PEDT) questionnaires, respectively. Results identified 182 (60.7%) men had Met S. Prevalence of PE was significantly higher in the subjects with Met S than the controls (35.2% vs 7.6%, p < 0.001). Patients with Met S and PE had significantly higher PEDT scores (15.4 vs 6.7), smaller waist circumference (108.3 cm vs 111.5 cm) and higher fasting blood sugar (187 mg% vs 161 mg%) than those with no PE (p < 0.001, 0.047 and 0.019, respectively). The other variables including IIEF-5 score, body mass index, serum triglycerides and high-density lipoprotein (14.98 vs 16.8, 30.6 vs 31.5, 192.9 mg% vs 178.1 mg% and 37.4 mg% vs 36.2 mg%, respectively) did not reveal significant differences. Both systolic hypertension and erectile dysfunction (ED) had significant associations (p = 0.047 and <0.001, respectively) with PE in Met S. In conclusion, PE has a high prevalence in Met S. Patients with Met S should be questioned about PE. Both ED and systolic hypertension may be associated with PE. Prevention of Met S should be considered, and this may be of help to decrease the prevalence of PE.
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Affiliation(s)
- Nader Salama
- a Department of Surgery (Unit of Urology) , Taibah Faculty of Medicine , Madina , Saudi Arabia
- b Department of Urology , Alexandria Faculty of Medicine , Alexandria , Egypt , and
| | - Ahmed Eid
- b Department of Urology , Alexandria Faculty of Medicine , Alexandria , Egypt , and
| | - Ahmed Swedan
- c Department of Internal Medicine , Alexandria Faculty of Medicine , Alexandria , Egypt
| | - Alaa Hatem
- b Department of Urology , Alexandria Faculty of Medicine , Alexandria , Egypt , and
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Chaudhary RK, Shamsi BH, Tan T, Chen HM, Xing JP. Study of the relationship between male erectile dysfunction and type 2 diabetes mellitus/metabolic syndrome and its components. J Int Med Res 2016; 44:735-41. [PMID: 27036148 PMCID: PMC5536719 DOI: 10.1177/0300060515623122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 11/24/2015] [Indexed: 01/30/2023] Open
Abstract
AIM To study the relationship between erectile dysfunction and type 2 diabetes mellitus (T2DM)/metabolic syndrome (MetS). METHODS This prospective study invited male patients with T2DM attending for a routine outpatient check-up to complete two questionnaires. A general questionnaire was used to collect demographic and clinical characteristics, while sexual function was assessed using the International Index of Erectile Function scoring system. The prevalence of MetS in this patient population was determined using information from the general questionnaire. Risk factors for erectile dysfunction were identified using univariate and multivariate logistic regression analyses. RESULTS A total of 175 patients provided valid questionnaires; of these, 148 (84.6%) had MetS. The prevalence of erectile dysfunction was 90.9% (159/175) in the entire survey population compared with 89.2% (132/148) in patients with MetS. Multivariate logistic regression analysis identified the following risk factors for erectile dysfunction in patients with T2DM and/or MetS: age, blood pressure and duration of diabetes. CONCLUSION These current findings suggest that the MetS and its components have a negative impact on male erectile function.
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Affiliation(s)
- Rakesh Kumar Chaudhary
- Department of Urology, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Bilal Haider Shamsi
- Department of Paediatrics, Shenmu Hospital, Shenmu County, Yulin City, Shaanxi Province, China
| | - Tan Tan
- Department of Urology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Hui-Ming Chen
- Department of Urology, Shaanxi Kangfu Hospital, Xi'an, Shaanxi Province, China
| | - Jun-Ping Xing
- Department of Urology, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
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Alashry SE, Gaballah MA, Malek HA, Elsalam AIA. Effect of Sildenafil on Non-Alcoholic Fatty Liver. INT J PHARMACOL 2015. [DOI: 10.3923/ijp.2015.814.820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Besiroglu H, Otunctemur A, Ozbek E. The Relationship Between Metabolic Syndrome, Its Components, and Erectile Dysfunction: A Systematic Review and a Meta-Analysis of Observational Studies. J Sex Med 2015; 12:1309-18. [DOI: 10.1111/jsm.12885] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Abdelhamed A, Hisasue SI, Shirai M, Matsushita K, Wakumoto Y, Tsujimura A, Tsukamoto T, Horie S. Testosterone replacement alters the cell size in visceral fat but not in subcutaneous fat in hypogonadal aged male rats as a late-onset hypogonadism animal model. Res Rep Urol 2015; 7:35-40. [PMID: 25767790 PMCID: PMC4354470 DOI: 10.2147/rru.s72253] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Patients with late-onset hypogonadism (LOH) benefit from testosterone replacement by improvement in the parameters of the metabolic syndrome, but fat cell morphology in these patients is still unclear. This study aims to determine the effect of testosterone replacement on the morphology of fat cells in subcutaneous and visceral adipose tissue and on erectile function in hypogonadal aged male rats as a model of LOH. Methods Ten male Sprague-Dawley rats aged 20–22 months were randomly allocated to two groups, ie, aged male controls (control group, n=5) and aged males treated with testosterone replacement therapy (TRT group, n=5). Testosterone enanthate 25 mg was injected subcutaneously every 2 weeks for 6 weeks. At 6 weeks, the intracavernous pressure (ICP) and mean arterial blood pressure (MAP) ratio was assessed. Visceral and subcutaneous adipose tissue specimens were collected and analyzed using Image-J software. Results Body weight at 2, 4, and 6 weeks after TRT was 800.0±35.4 g, 767.5±46.3 g, and 780±40.4 g, respectively (not statistically significant). The ICP/MAP ratio was 0.341±0.015 in the TRT group and 0.274±0.049 in the control group (not statistically significant). The median subcutaneous fat cell size was 4.85×103 (range 0.85–12.53×103) μm2 in the control group and 4.93×103 (range 6.42–19.7×103) μm2 in the TRT group (not statistically significant). In contrast, median visceral fat cell size was significantly smaller in the TRT group (4.93×103 μm2 [range 0.51–14.88×103]) than in the control group (6.08×103 μm2 [0.77–19.97×103]; P<0.001, Mann-Whitney U test). Conclusion This is the first study clearly indicating that TRT can decrease visceral fat cell size, which is a key modulator in the metabolic syndrome. However, a short course of TRT could not improve the ICP response in hypogonadal aged male rats. Further investigation is necessary to clarify the exact rationale of TRT on the visceral fat cell.
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Affiliation(s)
- Amr Abdelhamed
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan ; Department of Dermatology, Venereology and Andrology, Sohag University, Graduate School of Medicine, Sohag, Egypt
| | - Shin-Ichi Hisasue
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Masato Shirai
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Kazuhito Matsushita
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Yoshiaki Wakumoto
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Akira Tsujimura
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Taiji Tsukamoto
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
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Sanjay S, Bharti GS, Manish G, Rajeev P, Pankaj A, Puspalata A, Keshavkumar G. Metabolic syndrome: An independent risk factor for erectile dysfunction. Indian J Endocrinol Metab 2015; 19:277-282. [PMID: 25729692 PMCID: PMC4319270 DOI: 10.4103/2230-8210.149322] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE The objective was to determine the role of various components of metabolic syndrome (MetS) as independent risk factor for erectile dysfunction (ED). MATERIALS AND METHODS A total of 113 subjects of MetS, as recommended by recent IDF and AHA/NHLBI joint interim statement were selected for study who presented for ED. After doing Anthropometric examination, fasting laboratory assay for fasting plasma glucose (FPG), fasting insulin, hemoglobin A1c, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and 2 h oral glucose tolerance test (OGTT) was done. Erectile function was assessed by completing questions one through five of the International Index of Erectile Function (IIEF-5). A multiple linear regression analysis was carried out on 66 subjects with IIEF-5 score as dependent variable and components of MetS FPG, 2 h OGTT, TG, HDL, and waist circumference as independent variables. RESULTS Using a multiple linear regression analysis, we observed that presence of the various components of MetS was associated with ED and a decrease IIEF-5 score and this effect was greater than the effect associated with any of the individual components. Of the individual components of the MetS, HDL (B = 0.136; P = 0.004) and FPG (B = -0.069; P = 0.007) conferred the strongest effect on IIEF-5 score. However, overall age had most significant effect on IIEF-5 score. CONCLUSION It is crucial to formulate strategies and implement them to prevent or control the epidemic of the MetS and its consequences. The early identification and treatment of risk factors might be helpful to prevent ED and secondary cardiovascular disease, including diet and lifestyle interventions.
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Affiliation(s)
- Saran Sanjay
- Department of Endocrinology, LLRM Medical College, Meerut, India
| | | | - Gutch Manish
- Department of Endocrinology, LLRM Medical College, Meerut, India
| | - Philip Rajeev
- Department of Endocrinology, Pushpagiri Medical College Thiruvalla, Kerala
| | - Agrawal Pankaj
- Department of Endocrinology, Hormone Care and Research Centre, Ghaziabad, Uttar Pradesh, India
| | - Agroiya Puspalata
- Department of Ophthalmology, Subharti Medical College, Meerut, India
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Kaya E, Sikka SC, Gur S. A comprehensive review of metabolic syndrome affecting erectile dysfunction. J Sex Med 2015; 12:856-75. [PMID: 25675988 DOI: 10.1111/jsm.12828] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Metabolic syndrome (MetS) is the most important public health issue threatening the health of men and women all over the world. Its current prevalence (i.e., approximately 30%) is continuously increasing. MetS by itself is considered a risk factor for erectile dysfunction (ED). AIM To focus on the definition epidemiology, pathogenesis, and possible mechanistic links between MetS and ED in order to provide guidelines for treating such individuals. METHODS The search strategies yielded total records screened from PubMed. MAIN OUTCOME MEASURES Regardless of the definition, MetS consists of insulin resistance, hypertension, dyslipidemia, and obesity. MetS is not an end disease but is a disorder of energy utilization and storage. RESULTS The prevalence of ED in patients with MetS is almost twice than in those without MetS, and about 40% of patients with ED have MetS. An important mechanism linking MetS and ED is hypogonadism. CONCLUSIONS Recognizing through ED, underlying conditions such as hypogonadism, diabetes and MetS might be a useful motivation for men to improve their health-related choices. The clinical management of MetS can be done by therapeutic interventions that include lifestyle modifications, hormone replacement alone or in combination with phosphodiesterase 5 inhibitors, and other pharmacological treatments.
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Affiliation(s)
- Ecem Kaya
- Departments of Biochemistry and Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
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18
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The connection between type 2 diabetes and erectile dysfunction in Taiwanese aboriginal males. Int J Impot Res 2014; 26:235-40. [DOI: 10.1038/ijir.2014.26] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 06/03/2014] [Accepted: 06/13/2014] [Indexed: 12/15/2022]
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Takeuchi M, Hisasue SI, Hashimoto K, Tsukamoto T, Masumori N. Impact of visceral fat ratio on sleep-related erection: a retrospective study of elderly patients. Int J Urol 2014; 21:1046-50. [PMID: 24894589 DOI: 10.1111/iju.12497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/16/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the impact of visceral fat accumulation on the preoperative erectile function of elderly patients undergoing radical prostatectomy. METHODS A total of 83 patients who underwent radical prostatectomy from August 2005 through August 2013 were included in the present study. Findings at preoperative computed tomography scanning and sleep-related erection were used to determine the objective erectile function. Sleep-related erection was measured with an erectometer during at least three nights, and we assessed the maximum penile circumferential change. The visceral fat ratio was calculated as the ratio of the visceral fat area to the total subcutaneous fat area on computed tomography images, and the influence of these parameters on preoperative erectile function was assessed. RESULTS In simple linear regression analysis there was a strong correlation between the waist circumference and visceral fat ratio (P < 0.01). A visceral fat ratio of 55% was equivalent to a waist circumference of 85 cm, which is the standard value for central obesity in Japan. Furthermore, the factor that most negatively affected maximum penile circumferential change was the visceral fat ratio. In addition, only a visceral fat ratio of 55% or greater was a significant independent risk factor for declining maximum penile circumferential change in both univariate and multivariate analyses (P = 0.04 and 0.02, respectively). CONCLUSIONS The present study is the first to show the utility of the visceral fat ratio as an index of central obesity and the relationship with sleep-related erection in elderly men.
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Affiliation(s)
- Motoi Takeuchi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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20
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Aslan Y, Guzel O, Balci M, Tuncel A, Yildiz M, Atan A. The impact of metabolic syndrome on serum total testosterone level in patients with erectile dysfunction. Aging Male 2014; 17:76-80. [PMID: 24576299 DOI: 10.3109/13685538.2014.895318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the association between metabolic syndrome (MetS) and serum testosterone levels (TT) in patients with erectile dysfunction (ED). METHODS This study included 280 ED patients above 40-years-of-age. Participants were divided into two groups according to 2005 criteria of International Diabetes Federation. The severity of ED was determined according to the International Index of Erectile Function-EF (IIEF-EF score; 0-10 severe ED, 11-25 mild to moderate ED). The severity of ED, serum TT levels and other MetS components were compared between the groups. RESULTS The mean age of the patients was 55.7 ± 8.2 years. One hundred eighteen patients (%42.1) had MetS. Sixty-eight patients with MetS (57.6%) and 71 patients without MetS (43.8%) had severe ED (p = 0.031). A total of 46 (16.4%) patients had hypogonadism. Hypogonadism was seen more prevalent in patients with MetS (22.9% vs. 11.7%, p = 0.013). Logistic regression analyses for ED risk factors demonstrated that abnormal FBG increased the relative risk of severe ED up to 10.7-fold (p < 0.001) but not presence of hypogonadism (p = 0.706). CONCLUSION Metabolic syndrome was seen in almost half of the patients with ED. ED was more severe among MetS patients. Hypogonadism alone is a not risk factor for severe ED.
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Affiliation(s)
- Yilmaz Aslan
- Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health , Ankara , Turkey and
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21
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Liu LH, Zhang T, Zhang YR, Liu TS, Zhang HB, Chen FZ, He SH, Wei AY. Metabolic syndrome and risk for ED: a meta-analysis. Int J Impot Res 2014; 26:196-200. [PMID: 24599048 DOI: 10.1038/ijir.2014.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 10/29/2013] [Accepted: 12/20/2013] [Indexed: 12/12/2022]
Abstract
There are many recent observational studies on metabolic syndrome (MS) and the risk for ED, and it is still inconclusive whether MS increases the risk for ED. This meta-analysis aims to detect a relationship between MS and ED. We identified eligible studies by searching PubMed, Embase and the Cochrane Library for articles published before August 2013. Adjusted relative risks (RR) with 95% confidence interval (CI) were calculated using random-effects or fixed-effects models. A total of 10 studies involving 4092 participants were included in the meta-analysis. MS was associated with an increased incidence of ED (RR=1.60, 95% CI=1.27-2.02, P<0.001), with significant evidence of heterogeneity among these studies (P for heterogeneity <0.001, I(2)=92.9%). The subgroup and sensitivity analyses confirmed the stability of the results and no publication bias was detected. The present meta-analysis suggests that MS is significantly associated with the risk for ED. Large-scale and well-designed prospective studies are required to further investigate the association between MS and risk for ED.
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Affiliation(s)
- L H Liu
- Department of Urology, Medical Center for Overseas Patients, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - T Zhang
- Department of Urology, Medical Center for Overseas Patients, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Y R Zhang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - T S Liu
- Department of Thoracic and Cardiothoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - H B Zhang
- Department of Urology, Medical Center for Overseas Patients, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - F Z Chen
- Department of Urology, Medical Center for Overseas Patients, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - S H He
- The Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - A Y Wei
- Department of Urology, Medical Center for Overseas Patients, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Kassier S, Veldman F. When science meets culture: the prevention and management of erectile dysfunction in the 21st century. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2014. [DOI: 10.1080/16070658.2014.11734478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chen S, Wu R, Huang Y, Zheng F, Ou Y, Tu X, Zhang Y, Gao Y, Chen X, Zheng T, Yang Q, Wan Z, Zhang Y, Sun X, Liu G, Deng C. Insulin resistance is an independent determinate of ED in young adult men. PLoS One 2013; 8:e83951. [PMID: 24391852 PMCID: PMC3877124 DOI: 10.1371/journal.pone.0083951] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 11/11/2013] [Indexed: 01/25/2023] Open
Abstract
Background Insulin resistance (IR) triggers endothelial dysfunction, which contributes to erectile dysfunction (ED) and cardiovascular disease. Aim To evaluate whether IR was related to ED in young adult patients. Methods A total of 283 consecutive men complaining of ED at least six months were enrolled, with a full medical history, physical examination, and laboratory tests collected. Quantitative Insulin Sensitivity Check Index (QUICKI) was used to determine IR. The severity of ED was assessed by IIEF-5 questionnaire. Endothelial function was assessed by ultrasonographic examination of brachial artery flow mediated dilation (FMD). Results IR was detected in 52% patients. Subjects with IR had significant higher total cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-c), glycated haemoglobin (HBA1c), high sensitivity C-reactive protein (hs-CRP) and body mass index (BMI), but showed significant lower IIEF-5 score, FMD%, high density lipoprotein -cholesterol (HDL-c), testosterone, sex hormone binding globulin (SHBG) levels than patients without IR. Multiple regression analysis showed QUICKI and testosterone were independent predictors of IIEF-5 score. Furthermore, the incidence of IR was correlated with the severity of ED. Conclusions Compared with other CVFs, IR was found as the most prevalent in our subjects. Besides, IR was independently associated with ED and its severity, suggesting an adverse effect of insulin resistance on erectile function.
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Affiliation(s)
- Shengfu Chen
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Rongpei Wu
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yanping Huang
- Department of Urology, Shanghai Institute of Andrology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fufu Zheng
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yangbin Ou
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xiangan Tu
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yadong Zhang
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yong Gao
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xin Chen
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Tao Zheng
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Qiyun Yang
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Zi Wan
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yuanyuan Zhang
- Wake Forest University, Institute for Regenerative Medicine, Winston-Salem, North Carolina, United States of America
| | - Xiangzhou Sun
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
- * E-mail: (XS); (GL); (CD)
| | - Guihua Liu
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
- Wake Forest University, Institute for Regenerative Medicine, Winston-Salem, North Carolina, United States of America
- * E-mail: (XS); (GL); (CD)
| | - Chunhua Deng
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
- * E-mail: (XS); (GL); (CD)
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Akin Y, Gulmez H, Bozkurt A, Nuhoglu B, Usta MF. Usage of neck circumference as novel indicator of erectile dysfunction: a pilot study in Turkish population. Andrologia 2013; 46:963-70. [PMID: 24147908 DOI: 10.1111/and.12181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2013] [Indexed: 12/31/2022] Open
Abstract
Erectile dysfunction (ED) is the most common male sexual problem worldwide. The association between ED and components of metabolic syndrome (MtS) is well established. This study examined neck circumference (NC) as a possible indicator of MtS and also of ED. Ninety-two patients were included and divided into two groups. Group 1 consisted of 47 patients with ED and Group 2 consisted of 45 healthy volunteers. Questionnaires, differences in anthropometric and laboratory measurements between patients with ED and the control group, and a cut-off value for NC were investigated. The mean NC in ED patients was higher in Group 1 than in Group 2 (P = 0.001), and Group 1 also demonstrated more MtS criteria than Group 2 (P < 0.001). The cut-off point of NC was defined as 34.75 cm for ED and MtS. The cut-off values of waist circumference for ED and MtS were 105.5 and 102.5 cm respectively. In the light of these findings, NC may be a new component of MtS in ED patients. Additionally, NC may be a novel indicator of central obesity and ED. We suggest that NC values of 35 cm and over may predict ED in patients with MtS.
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Affiliation(s)
- Y Akin
- Department of Urology, Erzincan University School of Medicine, Erzincan, Turkey
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25
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Gacci M, Sebastianelli A, Salvi M, De nunzio C, Schiavina R, Simonato A, Tubaro A, Mirone V, Carini M, Carmignani G. Role of abdominal obesity for functional outcomes and complications in men treated with radical prostatectomy for prostate cancer: results of the Multicenter Italian Report on Radical Prostatectomy (MIRROR) study. Scand J Urol 2013; 48:138-45. [DOI: 10.3109/21681805.2013.803151] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Síndrome metabólica e disfunção eréctil - avaliação de parâmetros clínicos e hemodinâmicos. Rev Int Androl 2013. [DOI: 10.1016/j.androl.2012.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Chen K, Mi H, Gao Y, Tan A, Lu Z, Wu C, Liao M, Zhang Y, Mo Z. Metabolic Syndrome: A Potential and Independent Risk Factor for Erectile Dysfunction in the Chinese Male Population. Urology 2012; 80:1287-92. [DOI: 10.1016/j.urology.2012.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 08/17/2012] [Accepted: 08/21/2012] [Indexed: 12/19/2022]
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La Vignera S, Condorelli RA, Tumino S, Di Mauro M, Vicari E, Calogero AE. Original evaluation of endothelial dysfunction in men with erectile dysfunction and metabolic syndrome. Int J Impot Res 2012; 24:150-4. [PMID: 22551822 DOI: 10.1038/ijir.2012.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We have recently demonstrated the diagnostic value of a new immunophenotype of blood endothelial progenitor cells (EPCs=CD45neg/CD34pos/CD144pos) and endothelial microparticles (EMPs=CD45neg/CD144pos/AnnexinVpos) in patients with arterial erectile dysfunction (ED) according to severity of cavernous arterial insufficiency evaluated through penile Doppler. The aim of this study was to evaluate both EPCs and EMPs in patients with arterial ED and metabolic syndrome (MetS), comparing these patients with another group of patients without MetS and ED and a third group with MetS but without ED. For this study 50 patients with arterial ED and MetS were selected (age: 55.0±3.0 years; range: 47-60). A group of age-matched (age: 54.0±2.0 years; range: 44-60) patients without arterial ED and MetS (n=30), and another group of age-matched (age: 57.0±4.0 years; range: 40-62) patients with MetS but without ED (n=20) represented the control groups. EPCs and EMPs were significantly higher in patients compared with other groups (P<0.01). Both EPCs and EMPs correlated positively with the age, body mass index, and score of international index of ED (version five items) and with the following cavernous artery indices: peak systolic velocity, acceleration time and intima-media thickness. Among control groups patients with MetS but without ED showed serum concentrations of EPCs and EMPs significantly higher (P<0.05) compared with patients without MetS and ED. Patients with arterial ED and MetS have higher EPCs and EMPs compared with patients with MetS but without ED and patients without MetS and ED.
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Affiliation(s)
- S La Vignera
- Section of Endocrinology, Andrology and Internal Medicine, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy.
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Williams G. Aromatase up-regulation, insulin and raised intracellular oestrogens in men, induce adiposity, metabolic syndrome and prostate disease, via aberrant ER-α and GPER signalling. Mol Cell Endocrinol 2012; 351:269-78. [PMID: 22233684 DOI: 10.1016/j.mce.2011.12.017] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 12/22/2011] [Indexed: 01/28/2023]
Abstract
For some years now, reduced testosterone levels have been related to obesity, insulin resistance, type 2 diabetes, heart disease, benign prostatic hypertrophy and even prostate cancer--often considered guilty more by association, than actual cause--with little attention paid to the important role of increased intracellular oestrogen, in the pathogenesis of these chronic diseases. In the final stage of the steroidogenic cascade, testosterone is metabolised to oestradiol by P450 aromatase, in the cytoplasm of adipocytes, breast cells, endothelial cells and prostate cells, to increase intracellular oestradiol concentration at the expense of testosterone. It follows therefore, that any compound that up-regulates aromatase, or any molecule that mimics oestrogen, will not only increase the activation of the mainly proliferative, classic ER-α, oestrogen receptors to induce adipogenesis and growth disorders in oestrogen-sensitive tissues, but also activate the recently identified transmembrane G protein-coupled oestrogen receptors (GPER), and deleteriously alter important intracellular signalling sequences, that promote mitogenic growth and endothelial damage. This paper simplifies how stress, xeno-oestrogens, poor dietary choices and reactive toxins up-regulate aromatase to increase intracellular oestradiol production; how oestradiol in combination with leptin and insulin cause insulin resistance and leptin resistance through aberrant serine phosphorylation; how the increased oestradiol, insulin and leptin stimulate rapid, non-genomic G protein-coupled phosphorylation cascades, to increase fat deposition and create the vasoconstrictive, dyslipidemic features of metabolic syndrome; how aberrant GPER signalling induces benign prostatic hypertrophy; and how increased intracellular oestradiol stimulates mitogenic change and tumour-cell activators, to cause prostate cancer. In essence, the up-regulation of aromatase produces increased intracellular oestradiol, increases ER-α activation and increases GPER activation, in combination with insulin, to cause aberrant downstream transduction signaling, and thus induce metabolic syndrome and mitogenic prostate growth. To understand this fact, that raised intracellular oestradiol levels in men, induce and promote obesity, gynecomastia, metabolic syndrome, type two diabetes, benign prostatic hypertrophy and prostate cancer, rather than low testosterone, represents a shift in medical thinking, a new awareness, that will reduce the rising incidence of obesity, metabolic syndrome and prostate disease, and significantly improve the health of men worldwide.
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Affiliation(s)
- Graeme Williams
- Metabolic Endocrinology and Clinical Research, P.O. Box 1574, Noosa Heads, Qld. 4567, Australia.
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Arrabal-Polo MÁ, Arias-Santiago S, López-Carmona F, Merino-Salas S, Lahoz-García C, Zuluaga-Gómez A, Arrabal-Martín M. [Metabolic syndrome and hormone profile in patients with erectile dysfunction]. Actas Urol Esp 2012; 36:222-7. [PMID: 21959064 DOI: 10.1016/j.acuro.2011.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 07/25/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To demonstrate the existence of relation between metabolic syndrome and erectile dysfunction and to analyze the hormone profile of these patients regarding a healthy population group. MATERIAL AND METHODS A case-control study was designed with 65 men divided into 2 groups according to presence or non-presence of erectile dysfunction. Group A was made up of 37 men with erectile dysfunction and group B by 28 healthy men without erectile dysfunction. Ages ranged from 40 to 65 years. The presence of metabolic syndrome according to the ATPIII definition, performance of physical exercise, smoking habit, body mass index and complete hormone profile including testosterone -total, free and bioavailability, were studied. RESULTS Greater presence of metabolic syndrome was detected among men of Group A (72.9%) versus those of group B (17.8%) (p=0.0001). Among the parameters that make up the metabolic syndrome, there are differences between both groups in systolic and diastolic blood pressure, fast blood sugar and abdominal circumference, all these differences being significant. After performing multivariate analysis between the metabolic syndrome and erectile dysfunction adjusted for age, BMI, International Index for Erectile Function (IIEF), physical exercise and smoking habit, we have observed an independent significant relation between the metabolic syndrome and erectile dysfunction. We have not found differences between both groups in any hormone parameter. CONCLUSION A relationship is found between metabolic syndrome and erectile dysfunction. Thus, it seems recommendable to perform the metabolic profile and cardiovascular risk study in these patients.
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Affiliation(s)
- M Á Arrabal-Polo
- Servicio de Urología, Hospital Universitario San Cecilio, Granada, España.
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Lee RK, Chughtai B, Te AE, Kaplan SA. Sexual Function in Men with Metabolic Syndrome. Urol Clin North Am 2012; 39:53-62. [DOI: 10.1016/j.ucl.2011.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Tan WS, Ng CJ, Khoo EM, Low WY, Tan HM. The triad of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome: findings from a multi-ethnic Asian men study (The Subang Men's Health Study). Aging Male 2011; 14:231-6. [PMID: 22115177 DOI: 10.3109/13685538.2011.597463] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The etiology of erectile dysfunction (ED) is multi-factorial. This paper examines the association between ED, testosterone deficiency syndrome (TDS) and metabolic syndrome (MS) in Malaysian men in an urban setting. One thousand and forty-six men aged ≥ 40 years from Subang Jaya, Malaysia were randomly selected from an electoral-roll list. The men completed questionnaires that included: socio-demographic data, self-reported medical problems and the International Index of erectile function (IIEF-5). Physical examination and the following biochemical tests were performed: lipid profile, fasting blood glucose (FBG) and total testosterone. The response rate was 62.8% and the mean age of men was 55.8 ± 8.4 (41-93) years. Ethnic distribution was Chinese, 48.9%; Malay, 34.5%; Indian, 14.8%. The prevalence of moderate-severe ED was 20.0%, while 16.1% of men had TDS (< 10.4 nmol/L) and 31.3% of men had MS. Indian and Malay men were significantly more likely to have ED (p = 0.001), TDS (p < 0.001) and MS (p < 0.001) than the Chinese. Multivariate regression analysis showed that elevated blood pressure, elevated FBG, low high-density lipoprotein and heart disease were predictors of ED while all MS components were independently associated with TDS. Malay and Indian men have a higher disease burden compared to Chinese men and were more likely to suffer with ED, TDS and MS. MS components were closely related to TDS and ED.
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Affiliation(s)
- Wei Shen Tan
- Department of Surgery, North Middlesex University Hospital, London, UK.
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Abstract
The metabolic syndrome is common in countries with Western lifestyles. It comprises a number of disorders-including insulin resistance, hypertension and obesity-that all act as risk factors for cardiovascular diseases. Urological diseases have also been linked to the metabolic syndrome. Most established aspects of the metabolic syndrome are linked to benign prostatic hyperplasia (BPH) and prostate cancer. Fasting plasma insulin, in particular, has been linked to BPH and incident, aggressive and lethal prostate cancer. The metabolic syndrome has also been shown to be associated with nonprostatic urological conditions such as male hypogonadism, nephrolithiasis, overactive bladder and erectile dysfunction, although data on these conditions are still sparse. Overall, the results of studies on urological aspects of the metabolic syndrome seem to indicate that BPH and prostate cancer could be regarded as two new aspects of the metabolic syndrome, and that an increased insulin level is a common underlying aberration that promotes both BPH and clinical prostate cancer. Urologists need to be aware of the effect that the metabolic syndrome has on urological disorders and should transfer this knowledge to their patients.
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Schneider T, Gleissner J, Merfort F, Hermanns M, Beneke M, Ulbrich E. Efficacy and safety of vardenafil for the treatment of erectile dysfunction in men with metabolic syndrome: results of a randomized, placebo-controlled trial. J Sex Med 2011; 8:2904-11. [PMID: 21771281 DOI: 10.1111/j.1743-6109.2011.02383.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The prevalence of erectile dysfunction (ED) is increased in men with metabolic syndrome compared with the general population. AIM The aim of this study was to evaluate the efficacy and safety of vardenafil vs. placebo in men who had ED and metabolic syndrome. METHODS This was a 12-week, double-blind, randomized, multicenter, parallel-group, placebo-controlled prospective study in men with ED and metabolic syndrome (assessed by the International Diabetes Federation criteria). Vardenafil was administered at a starting dose of 10 mg, which could be titrated to 5 mg or 20 mg after 4 weeks, depending on efficacy and tolerability. MAIN OUTCOME MEASURES Primary efficacy measures were the erectile function domain of the International Index of Erectile Function (IIEF-EF) and Sexual Encounter Profile (SEP) diary questions 2/3. Secondary efficacy measures included SEP1, a diary question assessing ejaculation, the percentage of men achieving "return-to-normal" erectile function, and the percentage of men who titrated to a different dose. Adverse events (AEs) were recorded throughout the study. RESULTS The intent-to-treat population included 145 men (vardenafil, N = 75; placebo, N = 70). Baseline least squares IIEF-EF domain scores were low (vardenafil: 12.0; placebo: 12.7), indicative of moderate-to-severe ED. Vardenafil was statistically significantly superior to placebo for all primary efficacy measures (P < 0.0001) and showed nominally statistically significant superiority compared with placebo for SEP1/ejaculation success rates (P = 0.0003 and P < 0.0001, respectively) and the percentage of subjects reporting "return-to-normal" erectile function (P = 0.0004). Treatment-emergent AEs were mild-to-moderate in severity and consistent with the known AE profile of phosphodiesterase type 5 inhibitors. CONCLUSIONS This is the first study to assess the efficacy and safety of vardenafil, taken alone, for ED therapy in a population of men who all had metabolic syndrome. Although baseline erectile function in these patients was low, vardenafil treatment was associated with significant improvements in erectile function and rates of successful intercourse, and was well tolerated.
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Affiliation(s)
- Tim Schneider
- PUR/R Praxisklinik Urologie Rhein-Ruhr, Mülheim an der Ruhr, Germany.
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Chew KK, Gibson N, Sanfilippo F, Stuckey B, Bremner A. Cardiovascular Mortality in Men with Erectile Dysfunction: Increased Risk But Not Inevitable. J Sex Med 2011; 8:1761-71. [DOI: 10.1111/j.1743-6109.2011.02239.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Aoki H, Nagao J, Ueda T, Strong JM, Schonlau F, Yu-Jing S, Lu Y, Horie S. Clinical assessment of a supplement of Pycnogenol® and L-arginine in Japanese patients with mild to moderate erectile dysfunction. Phytother Res 2011; 26:204-7. [PMID: 21618639 DOI: 10.1002/ptr.3462] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 02/08/2011] [Accepted: 02/08/2011] [Indexed: 11/10/2022]
Abstract
A double-blind parallel group comparison design clinical study was conducted in Japanese patients with mild to moderate erectile dysfunction to investigate the efficacy of a supplement containing Pycnogenol® and L-arginine. Subjects were instructed to take a supplement (Pycnogenol® 60 mg/day, L-arginine 690 mg/day and aspartic acid 552 mg/day) or an identical placebo for 8 weeks, and the results were assessed using the five-item erectile domain (IIEF-5) of the International Index of Erectile Function. Additionally, blood biochemistry, urinalysis and salivary testosterone were measured. Eight weeks of supplement intake improved the total score of the IIEF-5. In particular, a marked improvement was observed in 'hardness of erection' and 'satisfaction with sexual intercourse'. A decrease in blood pressure, aspartate transaminase and γ-glutamyl transpeptidase (γ-GTP), and a slight increase in salivary testosterone were observed in the supplement group. No adverse reactions were observed during the study period. In conclusion, Pycnogenol® in combination with L-arginine as a dietary supplement is effective and safe in Japanese patients with mild to moderate erectile dysfunction.
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Affiliation(s)
- Hiromitsu Aoki
- Central Laboratories, Kobayashi Pharmaceutical Co., Ltd., 4-4-10 Doshomachi, Chuo-ku, Osaka, Japan
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Testosterone Deficiency and Risk Factors in the Metabolic Syndrome: Implications for Erectile Dysfunction. Urol Clin North Am 2011; 38:175-83. [DOI: 10.1016/j.ucl.2011.02.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tomada N, Tomada I, Botelho F, Cruz F, Vendeira P. Are all metabolic syndrome components responsible for penile hemodynamics impairment in patients with erectile dysfunction? The role of body fat mass assessment. J Sex Med 2010; 8:831-9. [PMID: 21091885 DOI: 10.1111/j.1743-6109.2010.02122.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a common disease that is mostly vasculogenic in nature. ED correlates with cardiovascular risk factors, with endothelial dysfunction being the common link. Hypertension (HTA) and insulin resistance are the most important determinants of arteriogenic ED, and are also components of the metabolic syndrome (MetS), which supports a strong association between MetS and ED. However, MetS and, specifically, obesity interference on penile hemodynamics is still controversial. AIM To evaluate the impact of independent MetS criteria and obesity on penile duplex Doppler ultrasound (PDDU) parameters in men with ED. METHODS Consecutive patients (n = 212) referred to a unit of PDDU were evaluated for cardiovascular risk factors and MetS (ATP III criteria). Body mass index and body fat percentage (BF%) were calculated. Each patient underwent a PDDU by the same investigator. Data are expressed as mean ± standard deviation, and statistical significance was considered at P level < 0.05. Statistical analysis of clinical, laboratory, and PDDU parameters was performed with SPSS® software. MAIN OUTCOME MEASURES To evaluate the individual power of MetS clusters and obesity as predictive factors for penile hemodynamic changes namely mean peak systolic velocity (mPSV). RESULTS MetS was present in 24.8% of men, and 80.8% of them presented penile hemodynamics alterations, with mPSV significantly lower comparatively to no MetS patients (29.0 vs. 35.4 cm/s, P = 0.004). Multivariate analysis demonstrated that, considering all MetS parameters, only HTA was significantly associated with diminished mPSV. However, after further adjustment for all cardiovascular risk factors, BF% remained the sole independent clinical factor for penile hemodynamics impairment. CONCLUSIONS There is a strong association between MetS and ED, but within MetS criteria, only HTA was independently associated with the deterioration of penile hemodynamics parameters. Although the classical methods of evaluating obesity in MetS were not individually associated with PDDU impairment, BF% represented by itself an excellent predictor of vascular ED.
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Affiliation(s)
- Nuno Tomada
- Department of Urology, Hospital de S. João, and Faculty of Medicine of Universidade do Porto, Portugal.
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Lee YC, Liu CC, Huang CN, Li WM, Wu WJ, Yeh HC, Wang CJ, Huang CH, Huang SP. The Potential Impact of Metabolic Syndrome on Erectile Dysfunction in Aging Taiwanese Males. J Sex Med 2010; 7:3127-34. [DOI: 10.1111/j.1743-6109.2010.01852.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Somani B, Khan S, Donat R. Screening for metabolic syndrome and testosterone deficiency in patients with erectile dysfunction: results from the first UK prospective study. BJU Int 2010; 106:688-90. [DOI: 10.1111/j.1464-410x.2009.09145.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Ranasinghe WK, Wright T, Attia J, McElduff P, Doyle T, Bartholomew M, Hurley K, Persad RA. Effects of bariatric surgery on urinary and sexual function. BJU Int 2010; 107:88-94. [DOI: 10.1111/j.1464-410x.2010.09509.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wang CC, Chancellor MB, Lin JM, Hsieh JH, Yu HJ. Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years. BJU Int 2010; 105:1136-40. [DOI: 10.1111/j.1464-410x.2009.08913.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Buvat J, Maggi M, Gooren L, Guay AT, Kaufman J, Morgentaler A, Schulman C, Tan HM, Torres LO, Yassin A, Zitzmann M. Endocrine Aspects of Male Sexual Dysfunctions. J Sex Med 2010; 7:1627-56. [DOI: 10.1111/j.1743-6109.2010.01780.x] [Citation(s) in RCA: 149] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Prophylactics of erectile dysfunction in patients with metabolic syndrome. Bull Exp Biol Med 2009; 148:318-21. [PMID: 20027358 DOI: 10.1007/s10517-009-0690-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
For prophylactics of erectile dysfunction in patients with metabolic syndrome, all unfavorable life-style factors should be excluded and all metabolic disturbances should be corrected. This will reduce the severity and stabilize the course of metabolic syndrome. Administration of special drugs is required for prevention of erection disturbances.
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Corona G, Mannucci E, Forti G, Maggi M. Hypogonadism, ED, metabolic syndrome and obesity: a pathological link supporting cardiovascular diseases. ACTA ACUST UNITED AC 2009; 32:587-98. [DOI: 10.1111/j.1365-2605.2008.00951.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Chew KK, Finn J, Stuckey B, Gibson N, Sanfilippo F, Bremner A, Thompson P, Hobbs M, Jamrozik K. Erectile dysfunction as a predictor for subsequent atherosclerotic cardiovascular events: findings from a linked-data study. J Sex Med 2009; 7:192-202. [PMID: 19912508 DOI: 10.1111/j.1743-6109.2009.01576.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION In spite of the mounting interest in the nexus between erectile dysfunction (ED) and cardiovascular (CV) diseases, there is little published information on the role of ED as a predictor for subsequent CV events. AIM This study aimed to investigate the role of ED as a predictor for atherosclerotic CV events subsequent to the manifestation of ED. Method. The investigation involved the retrospective study of data on a cohort of men with ED linked to hospital morbidity data and death registrations. By using the linked data, the incidence rates of atherosclerotic CV events subsequent to the manifestation of ED were estimated in men with ED and no atherosclerotic CV disease reported prior to the manifestation of ED. The risk of subsequent atherosclerotic CV events in men with ED was assessed by comparing these incidence rates with those in the general male population. MAIN OUTCOME MEASURE Standardized incidence rate ratio (SIRR), comparing the incidence of atherosclerotic CV events subsequent to the manifestation of ED in a cohort of 1,660 men with ED to the incidence in the general male population. RESULTS On the basis of hospital admissions and death registrations, men with ED had a statistically significantly higher incidence of atherosclerotic CV events (SIRR 2.2; 95% confidence interval 1.9, 2.4). There were significantly increased incidence rate ratios in all age groups younger than 70 years, with a statistically highly significant downward trend with increase of age (P < 0.0001) across these age groups. Younger age at first manifestation of ED, cigarette smoking, presence of comorbidities and socioeconomic disadvantage were all associated with higher hazard ratios for subsequent atherosclerotic CV events. CONCLUSIONS The findings show that ED is not only significantly associated with but is also strongly predictive of subsequent atherosclerotic CV events. This is even more striking when ED presents at a younger age.
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Affiliation(s)
- Kew-Kim Chew
- Keogh Institute for Medical Research, Nedlands, Perth, WA, Australia.
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Borges R, Temido P, Sousa L, Azinhais P, Conceição P, Pereira B, Leão R, Retroz E, Brandão Á, Cristo L, Sobral F. Metabolic Syndrome and Sexual (Dys)function. J Sex Med 2009; 6:2958-75. [DOI: 10.1111/j.1743-6109.2009.01412.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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