Erectile dysfunction may be the first clinical sign of insulin resistance and endothelial dysfunction in young men.

Abstract

OBJECTIVES:

The purpose of this study is to investigate the possible underlying pathogenesis of erectile dysfunction (ED) without well-known etiology in young men under the age of 40 years.

METHODS:

192 patients and 33 normal controls were enrolled. ED was evaluated by using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Traditional cardiovascular risk factors, hormone levels, and vascular parameters were measured. Insulin resistance (IR) was measured by homeostasis model assessment (HOMA).

RESULTS:

Patients with ED had significantly higher levels of systolic blood pressure (SBP), high-sensitivity C-reactive protein (Hs-CRP), high Insulin resistance index (HOMA-IR) and carotid intima-media thickness (IMT), compared with controls. The brachial artery endothelium-dependent flow-mediated vasodilation (FMD) values were significantly lower in ED patients. By multivariate logistic regression analysis, FMD, SBP, Hs-CRP and HOMA-IR were significantly associated with ED. In receiver-operating characteristic (ROC) analysis, FMD was a significant predictor of ED (area under the curve (AUC) 0.933, p < 0.001). The cutoff value of FMD <10.4 % had sensitivity of 81.3 % and specificity of 100 %. HOMA-IR was also proven to be predictor of ED (AUC of HOMA-IR 0.759, p < 0.001).

CONCLUSIONS:

ED may be the first clinical sign of endothelial dysfunction and a clinical marker of cardiovascular and metabolic diseases. Subclinical endothelial dysfunction and insulin resistance may be the underlying pathogenesis of ED in young patients without well-known etiology. Measurement of FMD, HOMA-IR can improve our ability to predict and treat ED, as well as subclinical cardiovascular disease early in young men.

• Authors: Fengjuan Yao, Lijuan Liu, Yan Zhang, Yanping Huang, Donghong Liu, Hong Lin, Yanqiu Liu, Rui Fan, Cuiling Li, Chunhua Deng
• Journal: Clinical research in cardiology : official journal of the German Cardiac Society (Clin Res Cardiol) Vol. 102 Issue 9 Pg. 645-51 (Sep 2013) ISSN: 1861-0692 [Electronic] Germany
• PMID: 23681359 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Blood Glucose
• Insulin
• C-Reactive Protein

Topics

• Adult
• Age Factors
• Area Under Curve
• Biomarkers (blood)
• Blood Glucose (analysis)
• Blood Pressure
• Brachial Artery (physiopathology)
• C-Reactive Protein (analysis)
• Cardiovascular Diseases (blood, diagnosis, epidemiology, physiopathology)
• Carotid Intima-Media Thickness
• Case-Control Studies
• China (epidemiology)
• Endothelium, Vascular (physiopathology)
• Erectile Dysfunction (blood, diagnosis, epidemiology, physiopathology)
• Humans
• Incidence
• Insulin (blood)
• Insulin Resistance
• Logistic Models
• Male
• Multivariate Analysis
• Odds Ratio
• ROC Curve
• Risk Factors
• Surveys and Questionnaires
• Vasodilation
• Young Adult