A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men

Eaton, Charles B.; Liu, Y L; Mittleman, Murray A.; Miner, Martin; Glasser, Dale B.; Rimm, Eric B.

doi:10.1038/sj.ijir.3901519

Cited by 64 publications

(43 citation statements)

References 34 publications

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“…10,[19][20][21][22] Several reports have shown that the presence and severity of ED are associated with inflammatory markers and endothelial dysfunction. 23,24 Similar pathogenic involvement of the nitric oxide (NO) pathway leading to the impairment of endothelium-dependent vasodilatation in the early phase, and obstructive vascular changes in the late phase, is shared by ED and other vascular diseases. 25,26 Therefore, atherosclerosis characterized by vascular damage and NO-pathway impairment may partially explain the association between ED, MS and CVD.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

Chu

Pan

et al. 2011

Int J Impot Res

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There is growing evidence of a link between ED, metabolic syndrome (MS) and cardiovascular disease (CVD). The study was to explore the prevalence of MS using three different definitions (World Health Organization (WHO), International Diabetes Foundation (IDF) and Adult Treatment Panel III (ATP III)), and to compare the association of CVD in ED outpatients using these definitions. This study enrolled 254 participants with a mean age of 55.3±0.9 years (range, 21 to 81 years) with ED as diagnosed by International Index of Erectile Function score. All participants underwent MS evaluation based on the three criteria. Differences of MS prevalence, demographical characteristics, biochemical profiles, pro-inflammatory and inflammatory markers, echocardiographic characteristics and the association with Framingham cardiac risk score (FCRS) were compared. The presence of diabetes mellitus (DM) in the WHO group and high waist girth in the IDF group were significant because of the necessity of respective criteria. The MS prevalence in the WHO, IDF and ATP III groups was 30.7, 34.3 and 36.6%, respectively (P ¼ 0.367). The degrees of agreement among each definition were substantial to perfect. No significant findings in echocardiographic characteristics, biochemical, inflammatory and pro-inflammatory markers were noted. The FCRS showed borderline nonsignificant difference (17.9 ± 0.4, 16.8 ± 0.4 and 16.9 ± 0.4, P ¼ 0.079); however, the FCRS was more closely correlated with the WHO than with the IDF and ATP III (Spearman's correlation coefficients were 0.522, 0.531 and 0.462, respectively; P ¼ 0.021). In patients o 55 years of age and those who smoke, the Spearman's correlation in the WHO group was significantly higher than in the IDF and ATP III groups. The prevalence of the MS using different definitions in ED patients was not different. The WHO-defined MS was more closely associated with CVD.

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Section: Discussionmentioning

confidence: 99%

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

Chu

Pan

et al. 2011

Int J Impot Res

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“…20 Indeed, atherosclerotic biomarkers for endothelial function, thrombosis and dyslipidemia are associated with the degree of ED. 21 In a longitudinal population-based study, after adjustment for the classical risk factors, severely decreased erectile rigidity has a hazard ratio of 2.6 and decreased erectile rigidity a hazard ratio of 1.6 for cardiovascular disease. 22 Three-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) decrease the action of oxidized LDL on endothelial cells, resulting in increased NO activity.…”

Section: Introductionmentioning

confidence: 99%

Atorvastatin improves the response to sildenafil in hypercholesterolemic men with erectile dysfunction not initially responsive to sildenafil

et al. 2009

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Despite the initial enthusiasm, the significant number of patients in whom sildenafil is contraindicated or ineffective is a major challenge to all urologists. Our aim was to determine the safety and efficacy of adjunctive atorvastatin in restoring normal erectile function in hypercholesterolemic (low-density lipoprotein (LDL) cholesterol 4120 mg per 100 ml) sildenafil nonresponders. The study comprised 131 men with ED not responding to sildenafil citrate. They were randomized either to 40 mg atorvastatin daily (n ¼ 66, group 1) or matching placebo (n ¼ 65, group 2) for 12 weeks while they were taking on-demand 100 mg sildenafil. Erectile function was subjectively assessed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire and response to the global efficacy question (GEQ). Serum biochemical and lipid profile (total cholesterol, triglycerides, LDL cholesterol and high-density lipoprotein cholesterol) analyses were performed at baseline and repeated at post-treatment weeks 6 and 12. Compared with the placebo group (59 patients, mean age ± s.d. 61.9 ± 6.1, mean years ED 3.9 ± 1.8), the atorvastatin group (59 patients, mean age±s.d. 63.9±6.9, mean years ED 3.7±1.6) had significantly greater improvements in all IIEF-5 questions (P ¼ 0.01) and GEQ (P ¼ 0.001). Subgroup analyses did reveal trends in the atorvastatin group to indicate that a change in the IIEF-5 score is affected by age, severity of ED and baseline serum levels of LDL. Patients with moderate (r ¼ 0.28, P ¼ 0.01) and severe (r ¼ 0.20, P ¼ 0.01) ED had better positive response rates to adjunctive atorvastatin than patients with mild to moderate ED. None of the patients taking atorvastatin achieved a response of 5 to the IIEF-5 questions and none of the patients regained normal erectile function as defined by the IIEF-5 score 421. Subjects experienced a statistically significant but modest improvement in erectile function. Further investigation is needed to test the usefulness of long-term atorvastatin administration to restore erectile function in sildenafil nonresponders.

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“…Various methods of endothelial function measurement are being used in research studies to establish and further elucidate the link between endothelial dysfunction and ED 4,6,8,9,[85][86][87][88] with the goal of establishing a simple diagnostic test for vasculogenic ED. [80][81][82][83][84][89][90][91] Clinical implications of endothelial function testing…”

Section: Measuring Endothelial Function In Relation To Edmentioning

confidence: 99%

The endothelial cell in health and disease: its function, dysfunction, measurement and therapy

et al. 2009

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Endothelial cells have numerous endocrine functions and contribute to a variety of processes, including penile erection and vasodilation. Endothelial dysfunction is associated with cardiovascular risk factors and has been implicated in the pathogenesis of atherosclerosis and ED. This study reviews endothelial function, in addition to endothelial dysfunction and its role in atherosclerosis and ED. Measurement of endothelial function is reviewed, including catheter-based methods, venous occlusion plethysmography, high-frequency ultrasound, peripheral arterial tonometry, digital pulse amplitude tonometry, digital thermal monitoring, the L-arginine test and measurement of compounds released by endothelial cells. Therapy and medications that improve endothelial function are reviewed. As the scientific community learns more about the importance of the endothelium, it is increasingly important for the clinician to understand endothelial function, dysfunction, measurement of endothelial function and therapies that affect this remarkable cell type.

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A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men

Cited by 64 publications

References 34 publications

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

Atorvastatin improves the response to sildenafil in hypercholesterolemic men with erectile dysfunction not initially responsive to sildenafil

The endothelial cell in health and disease: its function, dysfunction, measurement and therapy

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