Association of Type and Duration of Diabetes With Erectile Dysfunction in a Large Cohort of Men

Bacon, Constance G.; Hu, Frank B.; Giovannucci, Edward; Glasser, Dale B.; Mittleman, Murray A.; Rimm, Eric B.

doi:10.2337/diacare.25.8.1458

Cited by 212 publications

(138 citation statements)

References 43 publications

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“…24,33 In addition, this question has been used to evaluate the prevalence and incidence of ED in our large prospective cohort with strong associations with age, smoking, physical activity, alcohol use and diabetes, thus demonstrating good face validity. 2,34 The misclassification bias or measurement error introduced by us using a single retrospectively ascertained question about erectile function should lead to random misclassification, which should bias our results towards the null, thus leading to an underestimation of the association between erectile function and atherosclerotic biomarkers if a perfect measure of erectile function was available. Therefore, some of the null finding such as ours not finding an association between erectile function and inflammatory biomarkers such as CRP and IL-6 may be spurious owing to this misclassification bias.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2006

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Erectile dysfunction (ED) is associated with clinical atherosclerosis and several atherosclerotic risk factors including smoking, hypertension, dyslipidemia, diabetes mellitus, obesity and sedentary lifestyle. Clinical atherosclerosis is also associated with these same risk factors and with biomarkers of inflammation, thrombosis, endothelial cell activation.We evaluated the crosssectional association between the degree of ED and levels of atherosclerotic biomarkers. A subcohort of 988 US male health professionals between the ages 46 and 81 years as part of an ongoing epidemiologic study had atherosclerotic biomarkers measured from blood collected in 1994-1995. These same men had in 2000, been retrospectively asked about erectile function in 1995 and in 2000. Biennial questionnaires since 1986 assessed medical conditions, medications, smoking, physical activity, body mass index, alcohol intake. The retrospective assessment of erectile function in 2000 for 1995 in these 988 men ranged from very good -28.2%, good -25.1%, fair -19.2%, poor -13.6%, to very poor -13.9%. Men with poor to very poor erectile function compared to men with good and very good erectile function had 2.9 the odds of having elevated Factor VII levels (P ¼ 0.03), 1.9 times the odds of having elevated vascular cell adhesion molecule (P ¼ 0.13) and 2.0 times the odds of having elevated intracellular adhesion molecule (P ¼ 0.06) and 2.1 times the odds of having elevated total cholesterol/high-density lipoprotein ratio (P ¼ 0.02) comparing the top to bottom quintiles for each atherosclerotic biomarker after multivariate adjustment. Lipoprotein(a), homocysteine, interleukin-6 and tumor necrosis factor receptor, C-reactive protein and fibrinogen were not associated with the degree of erectile function after adjustment. We conclude that selected biomarkers for endothelial function, thrombosis and dyslipidemia but not inflammation are associated with the degree of ED in this cross-sectional analysis. Future studies evaluating the prospective association of ED, endothelial function and cardiovascular disease appear warranted.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2006

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“…Depending on the severity and duration of diabetes, the prevalence of ED ranges from 20% to 85%. 1,33,34 addition, an increase in the relative risk of ED was associated with increased duration of diabetes. 34 Erectile dysfunction is known to occur at an earlier age in men with diabetes than in those without it.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Erectile Dysfunction and Cardiovascular Disease: Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors in Men With Both Conditions

Nehra

2009

Mayo Clinic Proceedings

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Risk factors for cardiovascular disease and erectile dysfunction (ED) are similar, as might be expected given their shared etiologic and pathophysiologic origins. It is now generally accepted that most cases of ED result from a vascular disturbance of the endothelium. Recent epidemiological studies have documented a strong association between ED and comorbid conditions such as hypertension, diabetes mellitus, and dyslipidemia. Phosphodiesterase type 5 (PDE5) inhibitors are recommended as first-line therapy for erection problems of all etiologies and severities. The efficacy and safety of PDE5 inhibitors in the general ED population is well documented and has been extensively reviewed. To examine the association between ED and vascular disorders in the context of current knowledge regarding PDE5 inhibitors, an electronic search was performed of articles published from January 2002 through April 2008 using the PubMed, EMBASE, and MEDLINE databases. Although preference was given to randomized, blinded, controlled clinical trials, data from retrospective studies were also reviewed when appropriate. This analysis revealed that the clinical evidence linking ED to future cardiovascular events is compelling, presenting physicians with a unique interventional opportunity to address underlying cardiovascular health concerns in men presenting with ED. In most studies, PDE5 inhibitors were shown to effectively and safely improve erectile function regardless of cause, severity, or presence of comorbid conditions, including hypertension, diabetes mellitus, and dyslipidemia.

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“…E rectile dysfunction (ED) is a common complication of diabetes, with prevalence ranging between 27 and 75% (1)(2)(3). Despite the high prevalence of this condition in patients with diabetes, little is known regarding how diabetic subjects with ED differ from the general population of impotent men.…”

Section: Diabetes Care 26:1093-1099 2003mentioning

confidence: 99%

Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?

et al. 2003

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OBJECTIVE -Little is known regarding how diabetic men with erectile dysfunction (ED) differ from the general population of impotent men. The primary objective of this study was to compare disease-specific health-related quality of life (HRQOL) and severity of ED in impotent men with and without diabetes. RESEARCH DESIGN AND METHODS -Validated functional and HRQOL questionnaires (including the InternationalIndex of Erectile Function, the Sexual Self-Efficacy Scale, and the Psychological Impact of Erectile Dysfunction scales) were administered to patients in an ED disease registry. Men with ED and a history of diabetes (n ϭ 20) were compared with men with ED and no history of diabetes (n ϭ 90) at baseline and at the 12-month follow-up.RESULTS -Diabetic impotent men reported worse erectile function and intercourse satisfaction at baseline, and ED had a greater impact on their emotional life. Diabetic men with ED had significantly different trends over time in the Erectile Function (P Ͻ 0.001), Intercourse Satisfaction (P Ͻ 0.013), Sexual Desire (P Ͻ 0.016), Overall Satisfaction (P Ͻ 0.023), and the Sexual Experience-Psychological Impact domains (P Ͻ 0.002). In addition, there was a trend toward a difference over time in the Emotional Life-Psychological Impact domain (P Ͻ 0.067).CONCLUSIONS -Impotent men with diabetes present with worse ED than nondiabetic men with ED, resulting in worse disease-specific HRQOL in the diabetic men. Although diabetic patients initially respond well to ED treatment, responses do not appear to be durable over time. Therefore, clinicians must provide longer-term follow-up when treating ED in diabetic patients. Diabetes Care 26:1093-1099, 2003E rectile dysfunction (ED) is a common complication of diabetes, with prevalence ranging between 27 and 75% (1-3). Despite the high prevalence of this condition in patients with diabetes, little is known regarding how diabetic subjects with ED differ from the general population of impotent men. Comparison of randomized clinical trials assessing the efficacy of sildenafil show that diabetic men with ED differ from the general population of impotent men in their response to oral therapy (4,5). However, it is not known whether diabetic men present with worse sexual dysfunction than impotent patients from the general population or whether ED has a different impact on quality of life in diabetic men when compared with nondiabetic patients.In fact, little is known regarding the impact ED has on quality of life in diabetic subjects. To date, there has been a single study that specifically examined healthrelated quality of life (HRQOL) in impotent men with diabetes. De Berardis et al. (6) used the Short Form 36 (SF-36) to study general HRQOL in 1,460 men with diabetes. Of these patients, 34% reported frequent erectile problems. Impotent diabetic subjects were more likely to report depressive symptoms, have lower scores in the mental domains of the SF-36, and report a less satisfactory sex life. Although this cross-sectional study demonstrates that ED has a d...

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Association of Type and Duration of Diabetes With Erectile Dysfunction in a Large Cohort of Men

Cited by 212 publications

References 43 publications

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

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

Erectile Dysfunction and Cardiovascular Disease: Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors in Men With Both Conditions

Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?

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