Incidence of Metabolic Syndrome and Insulin Resistance in a Population with Organic Erectile Dysfunction

Abstract

Introduction Advanced age in men is accompanied by an increased prevalence of cardiovascular disease (CVD) and erectile dysfunction (ED). Prior studies revealed that 56% of an ED population have asymptomatic myocardial ischemia, 75% of men with CAD have symptoms of ED, and 91% of our ED patients have cardiovascular risks. Aim Because metabolic syndrome (MS) and insulin resistance (IR) are both predictors of CVD, we wished to evaluate these parameters in our population. Methods Our men (N = 154) were evaluated for multiple cardiovascular risk factors and graded on severity of ED. The severity of ED was evaluated by the Sexual Health Inventory for Men (SHIM) questionnaire. The prevalence of MS was determined by NCEP/ATP III criteria. Insulin resistance was measured by QUICKI. Main Outcome Measures Bivariate associations among total cholesterol/high-density lipoprotein (HDL), triglyceride/HDL, and Quantitative Insulin Sensitivity Check Index (QUICKI) were compared. Chi-square analysis was used to evaluate the relation between the presence and severity of IR with the severity of ED. Results The total cholesterol/HDL ratio was moderately and negatively correlated with QUICKI (r = −0.33; P < 0.01) and similarly for the triglyceride/HDL ratio (r = −0.32; P < 0.01). Metabolic syndrome was present in 43% of our ED population as opposed to 24% in a matched patient population. Approximately 79.2% of our total population had IR and 73.3% of the nondiabetic portion (N = 120) had IR, compared to 26% in a general population study. Metabolic syndrome (P = 0.01), IR (P = 0.01), and fasting blood sugar (FBS) >110 mg/dL (P = 0.01) correlated positively and moderately with increasing severity of ED by SHIM score. Conclusion Men with ED have a high incidence of MS and IR. Early detection of metabolic disease in patients with ED may be a gateway to the reduction endothelial dysfunction in younger men with increased cardiovascular risk but who present for treatment of ED alone.

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

“…Bansal et al 24 reported that the prevalence of MS in an ED population was 43%, but was only 24% in a matched control population. Similarly, Esposito et al 25 reported that in comparison with an age-and weight-matched control groups, patients with MS also exhibited an increased prevalence of ED.…”

“…17 Questions 1-5 and 15 of the IIEF constitute the erectile function domain, which is used to assess global erectile function. Scoring the IIEF domain of erectile function allowed the classification of each patient as follows: absent of ED (26)(27)(28)(29)(30), mild ED (17)(18)(19)(20)(21)(22)(23)(24)(25), moderate ED (11)(12)(13)(14)(15)(16) and severe ED (0-10).…”

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

“…7,8 The relationship of ED and MS had been well established by several studies. In the study by Bansal et al, 9 MS was found to occur in 43% of an ED population, whereas in only 24% of a matched patient population. Our previous study showed that the presence of MS, the number of MS components and certain traditional cardiovascular risk factors, especially high low-density lipoprotein cholesterol level and hypertension, may influence the ED severity.…”

Obesity, low testosterone levels and erectile dysfunction

“…84 As anticipated, the metabolic syndrome and insulin resistance are associated with ED. 85,86 In the Massachusetts Male Aging Study, ED was predictive of the presence of the metabolic syndrome only in nonobese men. In obese men, this association disappeared.…”