Department of Epidemiology, New England Research Institutes, Inc., Watertown, MA 02472, USA.
J Sex Med. 2011 Nov;8(11):3051-7. doi: 10.1111/j.1743-6109.2011.02423.x. Epub 2011 Aug 11.
Erectile dysfunction (ED) is thought to affect some 150 million men worldwide, but many men with ED symptoms do not seek treatment. Existing surveys suggest that men with severe ED and who report support from their partners are more likely to receive treatment than were others. Less is known, however, concerning the influence of sociomedical factors such as income and body composition on receipt of treatment.
The aim of this study was to determine the importance of socioeconomic status, comorbidities, and body composition on receipt of treatment for ED symptoms.
We used data on 638 men enrolled in the Boston Area Community Health (BACH) survey reporting ED symptoms and/or treatment for ED as evidenced by phosphodiesterase type 5 inhibitor (PDE5i) use. Logistic regression was employed to assess the relative strength of association between receipt of treatment and socioeconomic factors, body mass index, and medical factors. A replication of these results was then provided via a parallel model using the 2004 follow-up of the Men's Attitudes to Life Events and Sexuality (MALES).
In BACH, ED was deemed present if a subject scored 16 points or fewer on the five-item International Index of Erectile Function or reported PDE5i use. In MALES, presence of ED was indicated by use of a validated single question querying ED severity.
Controlling for age, body composition and other factors, increased household income, availability of a sexual partner, and provider diagnosis of high blood pressure were positively associated with treatment seeking via the use of PDE5i therapy in BACH. Results on data available in MALES produced similar results for household income and partner availability.
These data provide evidence that financial disadvantage may present a barrier to treatment of ED, an increasingly important sentinel marker of the cardiovascular and overall health among aging men.
勃起功能障碍（ED）被认为影响全球约 1.5 亿男性，但许多有 ED 症状的男性并未寻求治疗。现有调查表明，患有严重 ED 并报告得到伴侣支持的男性比其他男性更有可能接受治疗。然而，关于社会医学因素（如收入和身体成分）对接受 ED 治疗的影响知之甚少。
本研究旨在确定社会经济地位、合并症和身体成分对 ED 症状治疗的重要性。
我们使用了波士顿地区社区健康（BACH）调查中 638 名报告 ED 症状和/或接受 ED 治疗（如 PDE5i 使用）的男性的数据。使用逻辑回归评估了接受治疗与社会经济因素、体重指数和医学因素之间的相对关联强度。然后，通过使用 2004 年男性对生活事件和性行为的态度（MALES）的随访，使用平行模型复制了这些结果。
在 BACH 中，如果受试者在五项国际勃起功能指数中得分低于 16 分或报告 PDE5i 使用，则认为存在 ED。在 MALES 中，通过使用验证的单一问题查询 ED 严重程度来表示 ED 的存在。
在控制年龄、身体成分和其他因素后，家庭收入增加、性伴侣的可用性以及医生诊断的高血压与通过 PDE5i 治疗寻求治疗的可能性呈正相关。在 MALES 中可用数据的结果对于家庭收入和伴侣可用性也产生了类似的结果。
这些数据提供了证据表明，经济劣势可能成为 ED 治疗的障碍，ED 是越来越多的老年男性心血管和整体健康的重要指标。
