Rhoden Ernani Luis, Riedner Charles Edison, Fornari Alexandre, Fuchs Sandra Costa, Ribeiro Eduardo Porto
Surgery Department, Urology Division, at UCSPA and Postgraduate Course in Medical Sciences at UFRGS, Porto Alegre, Brazil.
J Sex Med. 2008 Nov;5(11):2662-8. doi: 10.1111/j.1743-6109.2008.00877.x. Epub 2008 Jun 17.
To investigate the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), while considering multiple risk factors for ED, including an anthropometric evaluation of central obesity.
A cross-sectional study was carried out with 192 consecutive male subjects (>or=40 years old). Conditions clearly associated with ED, other than obesity and age, were considered exclusion criteria. Men were evaluated routinely for clinical history, received a physical examination, and were subjected to blood analysis for fasting serum glucose, lipid profile, and serum testosterone. Patients with previous known history of diabetes mellitus or hypertension were excluded. Anthropometric measures taken included body mass index (general obesity) and waist circumference, waist-hip index, and sagittal abdominal diameter (visceral obesity). Analyses were performed using bivariate and multivariate models (multiple logistic regression). Age, education, alcohol consumption, smoking, sedentary lifestyle, fasting blood glucose level, dyslipidemia, hypogonadism, general obesity, and visceral obesity were taken into account as potential confounding factors.
All men completed the International Index of Erectile Function and International Prostate Symptom Score (IPSS).
IPSS scores were low, intermediate, and high in 89 (46.4%), 76 (39.6%), and 27 (14.1%) men, respectively. Overall IPSS scores were significantly associated with ED (P = 0.002). In addition, an association between the severity of ED and LUTS was observed (P = 0.008). The mean quality of life assessment in the IPSS revealed a statistically significant difference between individuals with varying degrees of ED (P = 0.008). The logistic regression analyses showed that IPSS scores and ED remained independently associated even after the control for confounding factors (odds ratio = 1.07, 95% CI = 1.02-1.13, P = 0.01).
This study suggests that LUTS are independently associated with ED, taking into account various risk factors for ED, including visceral obesity.
探讨下尿路症状（LUTS）与勃起功能障碍（ED）之间的关系，同时考虑ED的多种危险因素，包括对中心性肥胖进行人体测量评估。
对192名连续入选的男性受试者（年龄≥40岁）进行横断面研究。除肥胖和年龄外，明确与ED相关的疾病被视为排除标准。对男性进行常规临床病史评估、体格检查，并进行空腹血糖、血脂和血清睾酮的血液分析。排除既往有糖尿病或高血压病史的患者。所采取的人体测量指标包括体重指数（总体肥胖）、腰围、腰臀比和腹矢状径（内脏肥胖）。使用双变量和多变量模型（多重逻辑回归）进行分析。将年龄、教育程度、饮酒、吸烟、久坐生活方式、空腹血糖水平、血脂异常、性腺功能减退、总体肥胖和内脏肥胖作为潜在混杂因素进行考虑。
所有男性均完成国际勃起功能指数和国际前列腺症状评分（IPSS）。
IPSS评分低、中、高的男性分别有89名（46.4%）、76名（39.6%）和27名（14.1%）。总体IPSS评分与ED显著相关（P = 0.002）。此外，观察到ED严重程度与LUTS之间存在关联（P = 0.008）。IPSS中生活质量评估的平均值在不同程度ED的个体之间显示出统计学显著差异（P = 0.008）。逻辑回归分析表明，即使在控制混杂因素后，IPSS评分与ED仍保持独立关联（比值比 = 1.07，95%置信区间 = 1.02 - 1.13，P = 0.01）。
本研究表明，考虑到ED的各种危险因素，包括内脏肥胖，LUTS与ED独立相关。
