Association between Advanced Glycation End-Products, Carotenoids, and Severe Erectile Dysfunction

Association between sex hormones and erectile dysfunction in men without hypoandrogenism

In addition to testosterone, various endocrine hormones, such as dehydroepiandrosterone sulfate (DHEA-S) and estradiol, may be involved in erectile function. However, the role of these sex hormones in the erectile function of men without hypoandrogenism remains unclear. This cross-sectional study included 398 community-dwelling men without hypoandrogenism. The participants were categorized into the non-ED and ED groups. Multivariable logistic regression analyses were performed to investigate the relationship between ED and serum sex hormone levels, including total testosterone, DHEA-S, estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin. Among the 398 men, 66 (17%) and 332 (83%) were categorized into the non-ED and ED groups, respectively. In the multivariable analyses, serum DHEA-S and estradiol levels were significantly associated with ED (odds ratio [OR]: 0.996, P = 0.030; OR: 1.082, P = 0.002; respectively), whereas serum total testosterone, LH, FSH, and prolactin levels did not demonstrate significant association. After adjusting for age, none of neutrophil-to-lymphocyte ratio, serum plasminogen activator inhibitor-1 levels, and skin advanced glycation end-products levels demonstrated significant correlation with serum DHEA-S and estradiol levels. In conclusion, lower testosterone levels did not affect ED in men with normal testosterone levels, whereas serum DHEA-S and estradiol levels were significantly associated with ED.

Associations Between Serum Polar Oxygenated Carotenoids Level and Erectile Dysfunction in Men Older Than 40 Years

Lutein, zeaxanthin, and β-cryptoxanthin are polar oxygenated carotenoids found to be detectable in more than 95% of the population in the United States. Research has linked these carotenoids with lower coronary heart disease prevalence. This study investigates the association of serum lutein/zeaxanthin and β-cryptoxanthin with erectile dysfunction (ED) among middle-aged and older men in the United States. Serum lutein/zeaxanthin and β-cryptoxanthin were independent variables. The outcome variable was ED. Analyzed data from 1,302 men (≥40 years old) who participated in the National Health and Nutrition Examination Survey 2001-2002 cross-sectional study were included. After adjusting for all covariates, serum lutein/zeaxanthin negatively correlated with ED (odds ratio [OR]: 0.972, 95% confidence interval [CI]: [0.951, 0.994], p = .011). However, a U-shaped association between serum lutein/zeaxanthin and ED was detected in men with diabetes or prevalent cardiovascular disease. A U-shaped non-linear association was observed between β-cryptoxanthin levels and ED. These findings suggest that while both lutein/zeaxanthin and β-cryptoxanthin are recognized as essential antioxidants, maintaining lower serum lutein/zeaxanthin levels and appropriate serum β-cryptoxanthin levels may offer potential benefits for individuals with ED. Further investigations, particularly prospective studies, are warranted to determine the role of serum lutein/zeaxanthin and β-cryptoxanthin in the biological mechanism associated with ED.