Hyperuricaemia is an important risk factor of the erectile dysfunction: A systematic review and meta‐analysis

Abstract

Serum uric acid can affect endothelial function, and hyperuricaemia‐induced endothelial dysfunction is involved in the pathogenesis of cardiovascular diseases. As endothelial dysfunction is also a main pathogenic mechanism of erectile dysfunction (ED), the present study aims to evaluate the relationship between hyperuricaemia and ED via systemic review and meta‐analysis. Five cohort studies and six cross‐sectional studies on hyperuricaemia and ED, including a total of 454,510 participants, were recruited. Odds ratio (OR) and the 95% confidence intervals (CI) were adopted to estimate the relationship between hyperuricaemia and ED. Overall risk on effects of urate‐lowering therapy (ULT) were analysed. In addition, subgroup analyses on study design, populations, age stratification and the object were conducted. In the patients with hyperuricaemia, the risk of ED was 1.59‐fold higher than (pooled OR = 1.59, 95% CI [1.29, 1.97]) the non‐hyperuricaemia counterparts. Urate‐lowing therapy (ULT) in these hyperuricaemia patients reduced the risk of ED by 27% (OR = 1.27, 95% CI [1.14, 1.41]). After subgroup analysis, the association between hyperuricaemia and ED remained significant apart from the >60 years subgroup. Hyperuricaemia is an important risk factor of ED, while ULT can reduce the risk of ED in hyperuricaemia. This study suggests that hyperuricaemia‐associated endothelial dysfunction may also underlie the pathogenesis of ED in these patients.

Causal association between erectile dysfunction with urate levels and gout: a two-sample Mendelian randomization study

“…Meanwhile, an Italian study found that elevated UA levels might even serve as a predictor of the severity of ED 28 . According to a recently published meta-analysis, urate-lowering treatment could reduce the risk of ED by 27% in patients with hyperuricemia 11 . Several cohort studies have shown that the incidence of ED in patients with gout was 1.21-2.04 fold higher compared to those with gout 29 .…”

“…Hyperuricemia and gout have been demonstrated to induce endothelial dysfunction, which is the common pathogenesis of vascular ED 9,10 . Some cohort studies have demonstrated that ED incidence was signi cantly higher in patients with hyperuricemia or gout compared to those without hyperuricemia or gout 11,12 . Although considerable evidence supports the correlation of UA levels and gout in ED, the role of UA levels and gout in ED is still controversial.…”

Serum Uric Acid and Male Erectile Dysfunction: a Mendelian Randomization Study

“…5, after excluding each SNP, the overall error does not change much, indicating that the results are reliable. Multiple prior systematic reviews and meta-analyses have found that greater serum uric acid levels are related with the development of ED[8, 13,14]. Furthermore, clinical prediction model studies have demonstrated that serum UA can be used as a risk factor for ED [15].Furthermore, hyperuricemia may be regarded an independent risk factor in addition to known risk factors.…”