The role of male hypogonadism, aging, and chronic diseases in characterizing adult and elderly men with erectile dysfunction: a cross-sectional study

Abstract

Background Erectile function depends on a complex interaction between demographic, metabolic, vascular, hormonal, and psychological factors that trigger erectile dysfunction (ED). In the present study we carried out a cross-sectional study assessing the impact of non-communicable chronic diseases (NCDs), male hypogonadism, and demographic factors in characterizing men with ED. Four hundred thirty-three consecutive outpatients with ED were extracted from the electronic database from January 2017 to December 2019. The International Index of Erectile Function (IIEF) 5 score was used to diagnose ED and stratify its severity, standardized values of serum testosterone (10.5 nM/L) and luteinizing hormone (LH 9.4 IU/L) to diagnose and classify male hypogonadism and the Charlson Comorbidity Index (CCI) to weigh the role of each NCD on ED. Results Forty-six percent of participants were eugonadal (EuG), 13% had organic hypogonadism (OrH), and the remaining 41% had functional hypogonadism (FuH). Hypogonadal men had a significantly lower IIEF 5 score (p < .0001) than EuG. FuH had a higher CCI than OrH and EuG (all p < .0001). In a multivariable model, only free T (FT) and Sex Hormone Binding Globulin (SHBG) showed a direct correlation with the IIEF 5 score (all p < .0001). Age and CCI had an inverse correlation with IIEF 5 score (all p < .0001). Conclusion Serum FT, SHBG, and CCI are the leading determinants of ED severity. Besides overt hypogonadism, a relevant burden of severe NTCDs in middle-aged or older adults features the patient’s characteristics who will suffer from severe ED. Appropriate clinical approaches and, when necessary, treatments are required in these clusters of patients.

Computerized nailfold video‐capillaroscopy in type 2 diabetes: A cross‐sectional study on 102 outpatients

“…People living with type 2 diabetes (T2D) are at risk of developing microvascular and macrovascular complications, 1 with atherosclerotic cardiovascular disease (CVD) as the most relevant cause of comorbidity and mortality 2 . Microvascular complications, such as diabetic retinopathy (DR), micro‐ and macroalbuminuria, diabetic neuropathies, and erectile dysfunction, foster the risk of CVD, 3,4 also affecting the quality of life and general health status 5,6 …”

“…2 Microvascular complications, such as diabetic retinopathy (DR), micro-and macroalbuminuria, diabetic neuropathies, and erectile dysfunction, foster the risk of CVD, 3,4 also affecting the quality of life and general health status. 5,6 The computerized nailfold video-capillaroscopy (CNVC) is an imaging technique analyzing the microvasculature at the level of the toes and fingers in feet and hands. The method is used in numerous fields of medicine to assess microvascular injury in several conditions, including non-rheumatologic disorders such as hypertension, 6 T2D, 7 and endocrine diseases.…”

“… 2 Microvascular complications, such as diabetic retinopathy (DR), micro‐ and macroalbuminuria, diabetic neuropathies, and erectile dysfunction, foster the risk of CVD, 3 , 4 also affecting the quality of life and general health status. 5 , 6…”