Metabolic Clinic, Infectious Diseases Unit, Department of Medicine and Medicine Specialities, University of Modena and Reggio Emilia, Modena, Italy.
J Sex Med. 2012 Apr;9(4):1114-21. doi: 10.1111/j.1743-6109.2011.02243.x. Epub 2011 Apr 7.
The penis has been compared to a barometer of endothelial health, erectile dysfunction (ED) being an early sign of endothelial dysfunction.
The aim of the study was to investigate the extent of the association between ED and endothelial dysfunction in patients with human immunodeficiency virus (HIV) infection on antiretroviral therapy.
In this observational cross-sectional study, we evaluated the prevalence and factors associated with ED in a cohort of 133 HIV-infected men.
The International Index of Erectile Function, ultrasound assessment of brachial artery flow mediated dilatation (FMD), and multi-slice computed tomography for coronary artery calcifications (CAC) as surrogates of endothelial dysfunction, the Adult Treatment Panel III criteria to diagnose metabolic syndrome (MS), plasma total testosterone (hypogonadism), and a visual analogue scale (VAS) of aesthetic satisfaction of the face and of the body (psychological distress associated with lipodystrophy).
Thirty-nine (29.32%) patients had mild ED, 14 (10.52%) patients had moderate ED, and 26 (19.55%) patients had severe ED. Prevalence of ED ranged from 45% to 65%, respectively, in patients less than 40 and more than 60 years old. MS was present in 20 (25%) patients with ED and 13 (24%) patients without ED (P value = 0.87). Prevalence of ED neither appeared to be associated with MS as a single clinical pathological entity nor with the numbers of its diagnostic components. FMD < 7% was present in 25 (32%) patients with ED and 18 (33%) patients without ED (P value = 0.83), and CAC > 100 was present in 8 (10%) patients with ED and 5 (9%) patients without ED (P value = 0.87). A stepwise multivariable logistic regression analysis was used to find predictors of ED. Independent predictors were VAS face (odds ratio [OR] = 0.85, 95% confidence interval [CI] 0.73-0.99, P = 0.049) and age per 10 years of increase (OR = 1.73, 95% CI 1.02-2.94, P = 0.04).
Age constituted the most important risk factor for ED, which was related to aesthetic dissatisfaction of the face leading to negative body image perception.
阴茎被比作内皮功能健康的晴雨表，勃起功能障碍（ED）是内皮功能障碍的早期迹象。
本研究旨在探讨接受抗逆转录病毒治疗的人类免疫缺陷病毒（HIV）感染患者中 ED 与内皮功能障碍之间的关联程度。
在这项观察性横断面研究中，我们评估了 133 名 HIV 感染男性队列中 ED 的患病率和相关因素。
国际勃起功能指数、肱动脉血流介导的扩张（FMD）的超声评估、冠状动脉钙化（CAC）的多层计算机断层扫描作为内皮功能障碍的替代指标、成人治疗小组 III 标准诊断代谢综合征（MS）、血浆总睾酮（性腺功能减退）和面部及身体美学满意度的视觉模拟量表（VAS）（与脂肪营养不良相关的心理困扰）。
39 例（29.32%）患者存在轻度 ED，14 例（10.52%）患者存在中度 ED，26 例（19.55%）患者存在重度 ED。年龄小于 40 岁和大于 60 岁的患者 ED 患病率分别为 45%至 65%。20 例（25%）ED 患者和 13 例（24%）无 ED 患者存在 MS（P 值=0.87）。ED 既与作为单一临床病理实体的 MS 无关，也与 MS 的诊断组成部分的数量无关。25 例（32%）ED 患者的 FMD<7%，18 例（33%）无 ED 患者的 FMD<7%（P 值=0.83），8 例（10%）ED 患者的 CAC>100，5 例（9%）无 ED 患者的 CAC>100（P 值=0.87）。采用逐步多变量逻辑回归分析寻找 ED 的预测因素。独立预测因子为面部 VAS（比值比[OR] = 0.85，95%置信区间[CI] 0.73-0.99，P=0.049）和年龄每增加 10 岁（OR=1.73，95%CI 1.02-2.94，P=0.04）。
年龄是 ED 的最重要危险因素，与导致负面身体形象感知的面部美学不满有关。
