Grover Steven A, Lowensteyn Ilka, Kaouache Mohammed, Marchand Sylvie, Coupal Louis, DeCarolis Emidio, Zoccoli Joseph, Defoy Isabelle
Centre for the Analysis of Cost-Effective Care and the Division of General Internal Medicine, The Montreal General Hospital, Montreal, Quebec, Canada.
Arch Intern Med. 2006 Jan 23;166(2):213-9. doi: 10.1001/archinte.166.2.213.
The prevalence of erectile dysfunction (ED) and associated risk factors has been described in many clinical settings, but there is little information regarding men seen by primary care physicians. We sought to identify independent factors associated with ED in a primary care setting.
We surveyed a cross-sectional sample of 3921 Canadian men, aged 40 to 88 years, seen by primary care physicians. Participants completed a full medical history, physical examination, and measurement of fasting blood glucose and lipid levels. We used the International Index of Erectile Function to define ED as a score of less than 26 on the erectile function domain.
The overall prevalence of ED was 49.4%. The presence of cardiovascular disease (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.16-1.81; P<.01) or diabetes (OR, 3.13; 95% CI, 2.35-4.16; P<.001) increased the probability of ED after adjustment for other confounders. Among those individuals without cardiovascular disease or diabetes, the calculated 10-year Framingham coronary risk (OR, 1.03 per 1% increase; 95% CI, 1.02-1.05; P<.001) and fasting blood glucose levels (OR, 1.14 per 18-mg/dL [1-mmol/L] increase; 95% CI, 1.04-1.24; P<.01) were independently associated with ED. Erectile dysfunction was also independently associated with undiagnosed hyperglycemia (OR, 1.46; 95% CI, 1.02-2.10; P = .04), impaired fasting glucose (OR, 1.26; 95% CI, 1.08-1.46; P = .004), and the metabolic syndrome (OR, 1.45; 95% CI, 1.24-1.69; P<.001).
Cardiovascular disease, diabetes, future coronary risk, and increasing fasting glucose levels are independently associated with ED. It remains to be determined if ED precedes the development of these conditions.
勃起功能障碍（ED）的患病率及相关危险因素在许多临床环境中已有描述，但关于初级保健医生所诊治男性的相关信息却很少。我们试图确定在初级保健环境中与ED相关的独立因素。
我们对3921名年龄在40至88岁、由初级保健医生诊治的加拿大男性进行了横断面调查。参与者完成了完整的病史、体格检查以及空腹血糖和血脂水平的测量。我们使用国际勃起功能指数将ED定义为勃起功能领域得分低于26分。
ED的总体患病率为49.4%。在对其他混杂因素进行调整后，心血管疾病（比值比[OR]，1.45；95%置信区间[CI]，1.16 - 1.81；P <.01）或糖尿病（OR，3.13；95% CI，2.35 - 4.16；P <.001）会增加患ED的可能性。在那些没有心血管疾病或糖尿病的个体中，计算得出的10年弗雷明汉冠心病风险（OR，每增加1%为1.03；95% CI，1.02 - 1.05；P <.001）和空腹血糖水平（OR，每增加18 mg/dL[1 mmol/L]为1.14；95% CI，1.04 - 1.24；P <.01）与ED独立相关。勃起功能障碍还与未诊断出的高血糖（OR，1.46；95% CI，1.02 - 2.10；P =.04）、空腹血糖受损（OR, 1.26；95% CI，1.08 - 1.46；P =.004）以及代谢综合征（OR，1.45；95% CI，1.24 - 1.69；P <.
