Low serum folic acid can be a potential independent risk factor for erectile dysfunction: a prospective case–control study

Attia, Attia Abd Allah; Amer, Mohamed; Malekinejad, Hassan; Din, Sameh Fayek GamalEl

doi:10.1007/s11255-018-2055-y

Cited by 13 publications

(27 citation statements)

References 25 publications

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“…(2014) reported for the first time that serum FA levels in the ED group were significantly lower than those in the non‐ED group and suggested that FA deficiency might be one of the risk factors for ED. Several subsequent studies reported similar results and further suggested that the degree of FA deficiency was related to the severity of ED (Attia et al., 2019; Gupta et al., 2020; Karabakan et al., 2016). But recent cross‐sectional study of 1,381 participants found no significant difference in FA levels between ED patients and controls (Chen et al., 2019).…”

Section: Introductionmentioning

confidence: 64%

Serum folic acid levels and erectile dysfunction: A meta‐analysis and systematic review

Wang

Zhang

et al. 2021

Andrologia

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The aim of this study was to assess the relationship between serum folic acid (FA) levels and erectile dysfunction (ED) through a meta‐analysis. A research was conducted in MEDLINE via PubMed, Cochrane Library, EMBASE and Web of Science up to 22 November 2020 to identify studies related to FA and ED. Two authors independently screened the literature, evaluated methodological quality and extracted the data. We used RevMan5.3 and STATA 14.0 for meta‐analysis. A total of six studies including 1,842 participants were included, and the results showed that the FA levels in the non‐ED group were significantly higher than those in the ED group (MD = 3.37, 95% CI 1.49–5.52, p = 0.004). Subgroup analysis indicated that with the increase in ED severity, the difference in FA levels between groups was more obvious (MD: 1.99 vs. 4.63 vs. 5.63). The differences in FA levels between groups seem more significant in the younger group (MD = 4.87, 95% CI 2.58–6.89, p < 0.001) than in the older group (MD = 3.15, 95% CI 2.21–4.08, p < 0.001). In conclusion, FA deficiency is closely related to ED, and the degree of FA deficiency may reflect the severity of ED. In addition, the association seems to be more pronounced in the younger group.

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Section: Introductionmentioning

confidence: 64%

Serum folic acid levels and erectile dysfunction: A meta‐analysis and systematic review

Wang

Zhang

et al. 2021

Andrologia

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“…In various studies, age has not been significantly different between the groups and also did not correlate with FA levels (Elshahid et al, 2020;Karabakan et al, 2016;Sansone et al, 2017;Yang et al, 2014). Study by Attia et al (2019) demonstrated negative correlations between FA levels and age.…”

Section: Discussionmentioning

confidence: 88%

“…However, a study by Constantine et al found significantly lower FA levels in smokers (Vardavas et al, 2008). Another study found significantly reduced FA levels in smokers and rates of smoking directly correlated with the severity of ED (Attia et al, 2019).…”

Section: Discussionmentioning

confidence: 92%

“…In a study by Karabakan et al, 120 patients were divided into 4 groups based on severity (mild, moderate, severe and normal) of 40 each and was one of the first study to demonstrate significant decline FA levels with increasing severity (Karabakan et al, 2016). Another study including 60 patients of ED found significant decrease in FA levels with severity (Attia et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

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Novel predictive risk factor for Erectile Dysfunction: Serum folic acid

et al. 2020

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Erectile dysfunction (ED) is defined as the persistent inability to attain or maintain an erection sufficient to permit satisfactory sexual activity (Hatzimouratidis et al., 2016). Penile erection is a complex neurovascular phenomenon, and ED may result from various abnormalities arising from vasculogenic, neurogenic, hormonal, anatomical, drug-induced and psychogenic causes (Zhengyan et al., 2014). Endothelial dysfunction (EDys) has been found to be central to atherosclerosis which is one of the most common causes of ED (Gandaglia et al., 2014; Shah et al., 2016). EDys has also been linked to various risk factors like hypertension, diabetes, smoking and other oxidative stressors (Vlachopoulos et al., 2007). Thus, ED has been suggested to be an early marker of cardiovascular disease (CVD) (Shah et al., 2016). Endothelial cells have nitric oxide synthase (eNOS) which is responsible for the formation of nitric oxide (NO) which acts as a relaxing factor and plays a major role in activation and maintenance of the erection process (Aversa et al., 2010). Hyperhomocysteinaemia (HHcy) has a marked inhibitory effect on eNOS and promotes NOS uncoupling (Zhang et al., 2016). Folic acid (FA) has been demonstrated to play an important role in the metabolism of NO by potentially inverting NOS uncoupling (Stoll et al., 2010; Yang et al., 2014). FA supplementation has been found to improve endothelial dysfunction in patients with DM or hypertension (Cui et al., 2017; Hamidi Madani et al., 2013). Compared to the western countries, Asian population differ in genetic makeup, dietary and lifestyle profiles. It has also been found that nutritional deficiencies in FA account for increased

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“…Folate is an essential nutrient from the B group of vitamins and is present naturally in foods such as fruits and green leafy vegetables, kidney, and liver [11,12]. Tetrahydrofolate (THF), an important derivative of folate, plays an essential role in one-carbon metabolism, which involves the transfer of single-carbon units from donor molecules into biosynthetic pathways such as purine and pyrimidine biosynthesis [12,13].…”

Section: Biochemistry Of Folic Acidmentioning

confidence: 99%