Relationships of low‐grade systemic inflammation and nutritional status with erectile dysfunction severity in men on dialysis

Abstract

Background Low‐grade systemic inflammation and malnutrition are frequently observed in patients on dialysis and contribute to the development of endothelial dysfunction; however, the role of these conditions in erectile dysfunction (ED) severity remains to be elucidated. Objectives To investigate the relationships of low‐grade systemic inflammation and nutritional status with ED severity in men on dialysis. Materials and methods The present study included 71 men on dialysis. The sexual health inventory for men (SHIM) was used to assess ED. Men were classified as the mild/moderate (SHIM score ≥ 8) and severe ED (SHIM score ≤ 7) groups. C‐reactive protein/albumin ratio (CAR) and Geriatric Nutritional Risk Index (GNRI) were used to evaluate low‐grade systemic inflammation and nutritional status, respectively. We performed multivariate analysis to assess the relationships of CAR and GNRI with severe ED. Results The median age of the included men was 64 years old. All men had any degree of ED with 65% having severe ED. In the univariate analyses, a significant association was observed between elevated CAR (≥0.09) and severe ED (odds ratio [OR]: 4.038, p = 0.025), whereas no significant association was observed between lower GNRI (<92) and severe ED (OR: 2.357, p = 0.109). In the multivariate analysis, an association between elevated CAR and severe ED was still significant (OR: 5.985, p = 0.010). Discussion and conclusion Low‐grade systemic inflammation was significantly associated with ED severity, whereas lower GNRI was not. These results may be helpful for further research to identify the optimal treatment for men suffering from severe ED.

Association between Sex Hormones and Erectile Dysfunction in Men without Hypogonadism

“…Consequently, six multivariable regression analyses were performed. As low-grade systemic in ammation, endothelial dysfunction, and AGEs accumulation are well-known risk factors for ED 12,13 , multiple linear regression analyses were performed with serum DHEA-S and estradiol levels as dependent variables and age, neutrophil-to-lymphocyte ratio (NLR), serum von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1) levels, and skin AGEs levels as independent variables.…”

Systemic immune-inflammatory index and its association with female sexual dysfunction, specifically low sexual frequency, in depressive patients: Results from NHANES 2005 to 2016

“…Naoki et al included 71 dialysis patients in a cross-sectional study using the evaluation of erectile dysfunction (ED) conducted using the Sexual Health Inventory for Men (SHIM), which revealed a significant positive association between low-grade systemic inflammation and severe ED. [30] Giugliano et al investigated the relationship between visceral adiposity, chronic low-grade inflammation, and erectile function in a cohort of 80 obese male individuals. This study revealed significant correlations between ED and various inflammatory markers, including but not limited to IL-6, IL-8, IL-18, and CRP, alongside body weight and waist circumference.…”

Association between inflammatory indexes and erectile dysfunction in U.S. adults: National Health and Nutrition Examination Survey 2001-2004

“…In the predominantly proinflammatory environment, nitric oxide bioavailability is reduced and vasodilation is impaired due to inhibition of endothelial nitric oxide synthase expression and overproduction of reactive oxygen species, ultimately leading to endothelial dysfunction ( Figure 5 ). 18 …”