肥胖勃起功能障碍男性的雄激素缺乏与阴茎双功参数异常

Zohdy Wael, Kamal Emad Eldien, Ibrahim Yasser

University of Cairo-Department of Andrology, Cairo, Egypt;.

Elaj Center, Elaj Medical Group--Andrology, Jeddah Kingdom, Saudi Arabia.

J Sex Med. 2007 May;4(3):797-808. doi: 10.1111/j.1743-6109.2007.00499.x.

INTRODUCTION

The clinical identification of metabolic syndrome is based on measures of abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, and glucose intolerance. However, the impact of hypogonadism associated with obesity on penile hemodynamics is not well investigated.

AIM

In this retrospective study, we sought to evaluate the effect of obesity on serum total testosterone (TT) level and penile duplex parameters in men with erectile dysfunction (ED).

METHODS

Our participants (N = 158) were evaluated for erectile function using an abridged, five-item version of the International Index of Erectile Function-5. Determination of body mass index (BMI) was performed. Measurements of TT, fasting lipid profile, and blood sugar were conducted. Penile hemodynamics was assessed using intracavernosal injection and penile duplex study.

MAIN OUTCOME MEASURES

Bivariate associations among BMI and serum testosterone, blood pressure, and lipid profile, as well as penile duplex parameters. We compared all clinical, laboratory, and penile duplex parameters between lean men (BMI < 25) and overweight and obese men (BMI >or= 25).

RESULTS

The participants' age ranged between 20 and 56 years. A significant negative correlation between BMI and TT was detected (r = -0.431, P = 0.0001). Hypogonadism was identified in 54/158 (34.2%) of men with ED. The incidence of hypogonadism varied from as low as 1/18 (5.6%) in lean men to as high as 18/36 (50%) to 21/35 (60%) in morbid and severe obesity, respectively. Vasculogenic ED was detected in 32/54 (59.3%) men with BMI >or= 25, compared with 5/18 (27.8%) in lean men (P = 0.029). In order to study the effect of obesity on erectile function, cases with other risk factors were excluded. Of 67 men suffering from ED with no other risk factor(s) apart from obesity, vasculogenic ED was detected in 32/54 (59.3%) men with BMI >or= 25, compared with 3/13 (23.1%) in lean men (P = 0.029).

CONCLUSION

Obesity is associated with lower TT and disturbances of penile hemodynamics. It is an independent clinical factor for vasculogenic ED.

引言

代谢综合征的临床诊断基于腹部肥胖、致动脉粥样硬化血脂异常、血压升高和糖耐量异常的测量。然而，肥胖相关的性腺功能减退对阴茎血流动力学的影响尚未得到充分研究。

目的

在这项回顾性研究中，我们试图评估肥胖对勃起功能障碍（ED）男性血清总睾酮（TT）水平和阴茎双功能超声参数的影响。

方法

我们的参与者（N = 158）使用简化的五项版国际勃起功能指数-5评估勃起功能。测定体重指数（BMI）。检测TT、空腹血脂谱和血糖。使用海绵体内注射和阴茎双功能超声研究评估阴茎血流动力学。

主要观察指标

BMI与血清睾酮、血压和血脂谱以及阴茎双功能超声参数之间的双变量关联。我们比较了瘦男性（BMI < 25）与超重和肥胖男性（BMI≥25）之间的所有临床、实验室和阴茎双功能超声参数。

结果

参与者年龄在20至56岁之间。检测到BMI与TT之间存在显著负相关（r = -0.431，P = 0.0001）。在158例ED男性中有54例（34.2%）被诊断为性腺功能减退。性腺功能减退的发生率在瘦男性中低至1/18（5.6%），在病态肥胖和重度肥胖男性中分别高达18/36（50%）和21/35（60%）。在BMI≥25的32/54（59.3%）男性中检测到血管性ED，而在瘦男性中为5/18（27.8%）（P = 0.029）。为了研究肥胖对勃起功能的影响，排除了有其他危险因素的病例。在67例除肥胖外无其他危险因素的ED男性中，BMI≥25的32/54（59.3%）男性检测到血管性ED，而瘦男性中为3/13（23.1%）（P = 0.029）。