Department of Urology, Hospital de S. João, and Faculty of Medicine of Universidade do Porto, Portugal.
J Sex Med. 2011 Mar;8(3):831-9. doi: 10.1111/j.1743-6109.2010.02122.x. Epub 2010 Nov 22.
Erectile dysfunction (ED) is a common disease that is mostly vasculogenic in nature. ED correlates with cardiovascular risk factors, with endothelial dysfunction being the common link. Hypertension (HTA) and insulin resistance are the most important determinants of arteriogenic ED, and are also components of the metabolic syndrome (MetS), which supports a strong association between MetS and ED. However, MetS and, specifically, obesity interference on penile hemodynamics is still controversial.
To evaluate the impact of independent MetS criteria and obesity on penile duplex Doppler ultrasound (PDDU) parameters in men with ED.
Consecutive patients (n = 212) referred to a unit of PDDU were evaluated for cardiovascular risk factors and MetS (ATP III criteria). Body mass index and body fat percentage (BF%) were calculated. Each patient underwent a PDDU by the same investigator. Data are expressed as mean ± standard deviation, and statistical significance was considered at P level < 0.05. Statistical analysis of clinical, laboratory, and PDDU parameters was performed with SPSS® software.
To evaluate the individual power of MetS clusters and obesity as predictive factors for penile hemodynamic changes namely mean peak systolic velocity (mPSV).
MetS was present in 24.8% of men, and 80.8% of them presented penile hemodynamics alterations, with mPSV significantly lower comparatively to no MetS patients (29.0 vs. 35.4 cm/s, P = 0.004). Multivariate analysis demonstrated that, considering all MetS parameters, only HTA was significantly associated with diminished mPSV. However, after further adjustment for all cardiovascular risk factors, BF% remained the sole independent clinical factor for penile hemodynamics impairment.
There is a strong association between MetS and ED, but within MetS criteria, only HTA was independently associated with the deterioration of penile hemodynamics parameters. Although the classical methods of evaluating obesity in MetS were not individually associated with PDDU impairment, BF% represented by itself an excellent predictor of vascular ED.
勃起功能障碍（ED）是一种常见的疾病，主要是血管源性的。ED 与心血管危险因素相关，内皮功能障碍是共同的联系。高血压（HTA）和胰岛素抵抗是动脉性 ED 的最重要决定因素，也是代谢综合征（MetS）的组成部分，这支持 MetS 与 ED 之间存在很强的关联。然而，MetS 特别是肥胖对阴茎血流动力学的干扰仍存在争议。
评估独立的 MetS 标准和肥胖对 ED 男性阴茎双功能多普勒超声（PDDU）参数的影响。
连续评估 212 例接受 PDDU 检查的患者心血管危险因素和 MetS（ATP III 标准）。计算体重指数和体脂肪百分比（BF%）。每位患者均由同一位研究者进行 PDDU 检查。数据表示为平均值±标准差，P 值<0.05 时认为具有统计学意义。使用 SPSS®软件对临床、实验室和 PDDU 参数进行统计分析。
评估 MetS 簇和肥胖作为预测阴茎血流动力学变化（即平均收缩期峰值速度（mPSV））的独立因素的个体能力。
24.8%的男性存在 MetS，其中 80.8%的男性存在阴茎血流动力学改变，mPSV 明显低于无 MetS 的患者（29.0 与 35.4 cm/s，P = 0.004）。多变量分析表明，在考虑所有 MetS 参数的情况下，仅 HTA 与 mPSV 降低显著相关。然而，在进一步调整所有心血管危险因素后，BF%是唯一与阴茎血流动力学受损相关的独立临床因素。
MetS 与 ED 之间存在很强的关联，但在 MetS 标准中，仅 HTA 与阴茎血流动力学参数恶化独立相关。尽管评估 MetS 中肥胖的经典方法不能单独与 PDDU 损害相关，但 BF%本身是血管性 ED 的一个极好的预测指标。
