Kratzik Christian W, Schatzl Georg, Lunglmayr Gerhard, Rücklinger Ernst, Huber Johannes
Department of Urology, Medical University of Vienna, Vienna, Austria.
J Urol. 2005 Jul;174(1):240-3. doi: 10.1097/01.ju.0000162049.95483.51.
Erectile dysfunction (ED) may be associated with low serum total testosterone (T), low serum bioavailable testosterone (BAT) and high body mass index (BMI) in aging men.
A total of 675 workers (age range 45 to 60 years old) were entered into this study. Investigations were performed directly at their place of work. Exclusion criteria were abnormal urogenital status, antihypertensive drugs, medication possibly affecting the endocrine function and a history of previous pelvic trauma. T and sex hormone-binding globulin were measured with commercially available assays, and BAT was calculated from T and sex hormone-binding globulin. BMI was assessed and every individual completed a self-administrated questionnaire for erectile function (International Index of Erectile Function [IIEF-5]).
T and BAT showed a significantly negative correlation with age and BMI. Each additional year of increase in age caused a decrease in the IIEF-5 score of 0.195 (p <0.001). Increase in BMI by 1 kg/m reduced IIEF-5 by 0.141, independent of age (p =0.005). Multiple logistic regression analyses confirmed the influence of increased age and higher BMI on the risk of ED. The corresponding odds ratio for ED was 1.082 (p <0.001) and 1.076 (p <0.001), respectively. These data indicate an increase in ED risk by 8.2% per year and by 7.6% per kg/m BMI. Severe cases of ED (IIEF-5 score 7 or less) were significantly associated with a decrease in T and BAT. Individuals with low BAT (1 ng/ml or less) had a 3 times higher risk of severe ED compared with men with BAT greater than 1 ng/ml (odds ratio 3.045, 95% CI 1.088 to 8.522, p =0.034). The result of the multiple logistic regression analysis was adjusted to age and BMI, and did not show a significant influence on the incidence of severe ED.
BMI contributes strongly to ED. Low T or BAT are only relevant if IIEF-5 questionnaire results in severe ED.
在老年男性中，勃起功能障碍（ED）可能与血清总睾酮（T）水平低、血清生物可利用睾酮（BAT）水平低及体重指数（BMI）高有关。
共有675名年龄在45至60岁之间的工人参与了本研究。调查直接在他们的工作场所进行。排除标准包括泌尿生殖系统异常、正在服用抗高血压药物、可能影响内分泌功能的药物以及既往有盆腔创伤史。采用市售检测方法测量T和性激素结合球蛋白，并根据T和性激素结合球蛋白计算BAT。评估BMI，每位受试者完成一份关于勃起功能的自填问卷（国际勃起功能指数[IIEF-5]）。
T和BAT与年龄及BMI呈显著负相关。年龄每增加一岁，IIEF-5评分降低0.195（p<0.001）。BMI每增加1kg/m²，IIEF-5评分降低0.141，与年龄无关（p=0.005）。多因素logistic回归分析证实年龄增加和BMI升高对ED风险有影响。ED的相应比值比分别为1.082（p<0.001）和1.076（p<0.001）。这些数据表明，ED风险每年增加8.2%，BMI每增加1kg/m²，ED风险增加7.6%。重度ED病例（IIEF-5评分≤7）与T和BAT降低显著相关。BAT水平低（≤1ng/ml）的个体患重度ED的风险是BAT水平高于1ng/ml男性的3倍（比值比3.045，95%可信区间1.088至8.522，p=0.034）。多因素logistic回归分析结果经年龄和BMI校正后，对重度ED的发生率未显示出显著影响。
BMI对ED有很大影响。仅当IIEF-5问卷结果显示为重度ED时，低T或低BAT才具有相关性。
