Type 2 diabetes mellitus increases risk of erectile dysfunction independent of obesity and dyslipidemia: A Mendelian randomization study

Chi, Yuan; Jian, Zhongyu; Gao, Xiaoshuai; Jin, Xi; Wang, Menghua; Xiang, Liyuan; Li, Hong; Wang, Kunjie

doi:10.1111/andr.13132

Cited by 16 publications

(11 citation statements)

References 39 publications

(87 reference statements)

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“…However, the logistic regression analysis showed that, along with the new diagnosis of DM, hypertension and age worsen the severity of ED, but not BMI. In this regard, a recent study conducted by Yuan et al highlighted that DM showed a direct causal effect on ED, independent of obesity and dyslipidemia [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Erectile dysfunction as a marker of endocrine and glycemic disorders

Mazzilli¹,

Zamponi²,

Olana³

et al. 2022

J Endocrinol Invest

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Purpose The aim of this study was to evaluate in a population of patients with erectile dysfunction (ED): (a) the prevalence of a previously unknown endocrine/glycemic disorders; (b) the correlation between ED severity and endocrine/glycemic disorders. Methods 1332 patients referred for ED from 2013 to 2020 were included. The ED diagnosis was made using the International-Erectile-Function-Index-5 questionnaire. ED severity was considered according to presence/absence of spontaneous erections, maintenance/achievement deficiency. All patients were subjected to search for sociodemographic and clinical characteristics: age, ethnicity, marital status, previous use of PDE5i, previous prostatectomy, diabetes mellitus (DM), prediabetes, endocrine dysfunctions. Results The mean ± SD age was 54.3 ± 13.7 years. The 19.1% (255/1332) of patients were already in treatment for prediabetes/diabetes or endocrine dysfunctions. Among the remaining 1077, the prevalence of previously unknown endocrine and glycemic disorders was 30% (323/1077). Among them, 190/323 subjects (58.8%) were affected by hypogonadism, with high estradiol level observed in 8/190 (4.2%). The prevalence of new glycemic alterations was 17.3% (56/323) [specifically, 32/56 (57.1%) DM, and 24/56 (42.9%) prediabetes]. A thyroid dysfunction was observed in 40/323 subjects (12.3%) and hyperprolactinemia in 37/323 (11.5%). Patients with new diagnosis of DM showed more severe form of ED compared to the total group {difficulty in the achievement of erection: 46/56 [82.2%, vs 265/1332 (19.9%), p < 0.05]; absence of spontaneous erection 23/56 [41.1%, vs 321/1332 (24.1%), p < 0.05]}. Conclusion ED is an early marker of endocrine/glycemic disorder, and a previously unknown dysfunction was found in more than a quarter of patients. A newly diagnosed DM is associated with ED severity, especially in elderly man and in presence of hypertension.

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Section: Discussionmentioning

confidence: 99%

Erectile dysfunction as a marker of endocrine and glycemic disorders

Mazzilli¹,

Zamponi²,

Olana³

et al. 2022

J Endocrinol Invest

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“…An aberrant vascular response to insulin and subsequent vasoconstriction have been observed in individuals with insulin resistance; these issues may contribute to ED ( 23 , 25 ). A mendelian randomization study showed that T2DM has a causal relationship with ED independently from obesity and dyslipidemia ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

The Association Between FGF21 and Diabetic Erectile Dysfunction: Evidence from Clinical and Animal Studies

Yang

Zhang²,

Xiaohui³

et al. 2022

Front. Endocrinol.

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Erectile dysfunction (ED), a complication of diabetes mellitus (DM), affects 50–75% of men with diabetes. Fibroblast growth factor 21 (FGF21) is a liver-derived metabolic regulator which plays a role in insulin-independent glucose uptake in adipocytes. We designed a clinical study and an animal experiment to investigate the relationship between FGF21 and DM-induced ED. The clinical study enrolled 93 participants aged > 18 years (61 patients with type 2 DM and 32 healthy controls) from Taian City Central Hospital (TCCH) in Shandong Province, China, amongst whom the association between serum FGF21 and diabetic ED was analyzed. To further validate this association, we developed animal model of diabetic ED using Sprague-Dawley (SD) rats. Serum FGF21 concentration and FGF21 mRNA expression in penile samples of the rats were determined with Western blotting and quantitative real-time PCR. Among the 93 participants, the level of serum FGF21 was negatively correlated with the IIEF-5 score (r = -0.74, P < 0.001). The analysis on the performance of FGF21 for ED diagnosis showed that the area under the receiver operating characteristic (ROC) curve was 0.875 (95% confidence interval [CI]: 0.803 to 0.946). In the animal experiment, the levels of serum FGF21, 2-Δ Δ Ct values of FGF21 mRNA expression, and relative levels of FGF21 in penile samples were higher in the ED group compared to the DM and control groups. Our findings demonstrated an association between the FGF21 level and diabetic ED, indicating the potential of this cytokine in predicting diabetic ED.

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“…A comparison of the two groups showed that increased LH and PRL were associated with an increased risk of more severe ED in the DMED population. This can be attributed to diabetes-induced m e t a b o l i c s y n d r o m e le a d i n g t o e l e v a t e d L H a n d hyperprolactinemia (HyperPRL) causing ED, and the related mechanisms are currently being studied (25)(26)(27)(28)(29)(30)(31). Therefore, screening and appropriate interventions for men with erectile dysfunction is warranted (32).…”

Section: Discussionmentioning

confidence: 99%

Comparison of characteristics between Chinese diabetes mellitus-induced erectile dysfunction populations and non-diabetes mellitus-induced erectile dysfunction populations: A cross-sectional study

Peng

Liu

et al. 2022

Front. Endocrinol.

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BackgroundErectile dysfunction (ED) is a common disease in adult men, and diabetes is an independent risk factor for ED. However, there are few reports on the distinction between diabetes mellitus-induced erectile dysfunction (DMED) and non-DMED features, as well as ED features of varying severity in the two groups.MethodsA total of 365 ED patients treated at two clinics in China from 2019 to 2022 were included. Questionnaires of the International Index of Erectile Function (IIEF-5), Erectile Hardness Score (EHS), Premature Ejaculation Diagnostic Tool (PEDT), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) were administered to the patients. They were divided into three groups according to the IIEF-5 score: 5-7 for severe ED, 8-11 for moderate ED, and 12-21 for mild ED. In addition, the patient’s age, weight, height, fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), total testosterone (TT) and other indicators were also collected. Statistical analysis was performed using SPSS 26, comparing all parameters between groups.ResultsAge (P<0.001), height (P=0.009), body mass index (BMI) (P=0.002), PEDT (P<0.001), FBG (P<0.001), FSH (P<0.001), TG (P<0.001), TT (P<0.001) and triglyceride-glucose index (TyG) (P<0.001) were significantly different between diabetic ED and nondiabetic ED subjects. The trend test in the nondiabetic ED population found a negative correlation between the IIEF-5 score and PHQ-9 (P for trend=0.15). Multivariate ordinal logistic regression in the diabetic ED population showed that elevated LH OR=11.37 (95% CI: 0.966, 3.897) and elevated PRL OR=4.10 (95% CI: 0.410, 2.411) were associated with an increased risk of more severe ED.ConclusionsThe aetiology, demographic parameters, degree of premature ejaculation, and related biochemical tests were significantly different between the DMED and non-DMED populations.

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Type 2 diabetes mellitus increases risk of erectile dysfunction independent of obesity and dyslipidemia: A Mendelian randomization study

Cited by 16 publications

References 39 publications

Erectile dysfunction as a marker of endocrine and glycemic disorders

Erectile dysfunction as a marker of endocrine and glycemic disorders

The Association Between FGF21 and Diabetic Erectile Dysfunction: Evidence from Clinical and Animal Studies

Comparison of characteristics between Chinese diabetes mellitus-induced erectile dysfunction populations and non-diabetes mellitus-induced erectile dysfunction populations: A cross-sectional study

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