Division of Urology, Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy.
Int J Impot Res. 2010 May-Jun;22(3):204-9. doi: 10.1038/ijir.2010.1. Epub 2010 Feb 11.
This study was designed to evaluate the prevalence and correlates of ED in a population of diabetic men. Consecutive patients with type 2 diabetes were recruited among outpatients regularly attending Diabetes Clinics. Inclusion criteria for the initial selection of patients were a diagnosis of type 2 diabetes for at least 6 months but less than 10 years, age 35-70 years, body mass index (BMI) of 24 or higher, HbA1c of 6.5% or higher: a total of 555 (90.8%) of the 611 men were analyzed in this study. ED was assessed by the IIEF-5 instrument. Approximately, 6 in 10 men in our sample of diabetic men had varying degrees of erectile dysfunction: mild 9%, mild to moderate 11.2%, moderate 16.9% and severe 22.9%. The prevalence of severe ED increased with age. Higher hemoglobin A1c (HbA1c) levels were associated with ED; similarly, the presence of metabolic syndrome, hypertension, atherogenic dyslipidemia (low levels of HDL-cholesterol and high levels of triglycerides) and depression was associated with ED. Physical activity was protective of ED; men with higher levels of physical activity were 10% less likely to have ED as compared with those with the lowest level. In conclusion, among subjects with type 2 diabetes glycemic control and other metabolic covariates were associated with ED risk, whereas higher level of physical activity was protective. These results encourage the implementation of current medical guidelines that place intensive lifestyle changes as the first step of the management of type 2 diabetes.
本研究旨在评估糖尿病男性人群中勃起功能障碍（ED）的患病率及其相关因素。连续招募了定期在糖尿病诊所就诊的 2 型糖尿病门诊患者。患者入选的初始标准为：诊断为 2 型糖尿病至少 6 个月但不足 10 年，年龄 35-70 岁，体重指数（BMI）≥24，糖化血红蛋白（HbA1c）≥6.5%：在这项研究中，共分析了 611 名男性中的 555 名（90.8%）。ED 采用 IIEF-5 量表评估。我们的糖尿病男性样本中，约有 6 成男性存在不同程度的勃起功能障碍：轻度 9%，轻度至中度 11.2%，中度 16.9%，重度 22.9%。重度 ED 的患病率随年龄增长而增加。较高的糖化血红蛋白（HbA1c）水平与 ED 相关；同样，代谢综合征、高血压、致动脉粥样硬化血脂异常（HDL-胆固醇水平低和甘油三酯水平高）和抑郁的存在也与 ED 相关。身体活动对 ED 具有保护作用；与活动水平最低的男性相比，活动水平较高的男性发生 ED 的可能性低 10%。总之，在 2 型糖尿病患者中，血糖控制和其他代谢因素与 ED 风险相关，而较高的身体活动水平具有保护作用。这些结果鼓励实施当前的医学指南，将强化生活方式改变作为 2 型糖尿病管理的第一步。
