Giner Miguel Angel, Rovira Eduardo, Julve Raúl, Salvador Maria Isabel, Naval Elsa, Puertas Francisco Javier, Bou Ricardo
Unidad HTA, Servicio Medicina Interna, Hospital Universitario de La Ribera, Valencia, España.
Med Clin (Barc). 2012 Sep 8;139(6):243-8. doi: 10.1016/j.medcli.2011.05.022. Epub 2011 Sep 22.
Obstructive sleep apnea (OSA) syndrome can contribute to the development of erectile dysfunction (ED) through multiple mechanisms. The aim was to identify factors influencing the presence of ED in these patients.
Cross sectional study in men diagnosed with OSA by polysomnography. We obtained information about demographic variables, apnea-hypopnea index (AHI), comorbidity, blood pressure, drugs, Epworth Sleepiness Scale, physical examination, electrocardiogram, ankle-brachial index and blood and urine analysis. The presence of ED was assessed by questionnaire IIEF-5.
We included 142 patients, mean age was 53 (11) years. The prevalence of ED was 69%. We found significant differences in AHI between patients with mild and severe ED (41 [21] vs 63 [18], P=.023). ED was associated with hypertension (odds ratio [OR]=3.56 [1.64-7.72]), hypercholesterolemia (OR=7.19 [2.39-21.68]), diabetes mellitus type 2 (OR=3.07 [1.02-9.48]) and ischemic heart disease (OR=1.51 [1.33-1.70]); and treatment with antihypertensive (OR=4.05 [1.76-9.31)], lipid-lowering drugs (OR=9.71 [2.2-22.72]), anti-diabetic drugs (OR=3.21 [0.69-14.89]), antiplatelet and anticoagulant agents (OR=6.44 [1.45-28.64]). After logistic regression analysis, only age (OR=1.11 [1.05-1.16]) and hypercholesterolemia (OR=4.87 [1.49-15.96]) were associated with ED.
Patients with OSA have a high prevalence of ED, mainly in severe OSA. Factors influencing the presence of ED in patients with OSA are primarily age and hypercholesterolemia. Other factors that may be related include hypertension, poor metabolic control, ischemic heart disease, and treatment with antihypertensive, lipid-lowering and anti-diabetic drugs.
阻塞性睡眠呼吸暂停（OSA）综合征可通过多种机制导致勃起功能障碍（ED）。本研究旨在确定影响这些患者发生ED的因素。
对经多导睡眠图诊断为OSA的男性进行横断面研究。我们获取了有关人口统计学变量、呼吸暂停低通气指数（AHI）、合并症、血压、药物、爱泼华嗜睡量表、体格检查、心电图、踝臂指数以及血液和尿液分析的信息。通过国际勃起功能指数问卷（IIEF-5）评估ED的存在情况。
我们纳入了142例患者，平均年龄为53（11）岁。ED的患病率为69%。我们发现轻度和重度ED患者的AHI存在显著差异（41[21]对63[18]，P = 0.023）。ED与高血压（比值比[OR]=3.56[1.64 - 7.72]）、高胆固醇血症（OR = 7.19[2.39 - 21.68]）、2型糖尿病（OR = 3.07[1.02 - 9.48]）和缺血性心脏病（OR = 1.51[1.33 - 1.70]）相关；以及与使用抗高血压药物（OR = 4.05[1.76 - 9.31]）、降脂药物（OR = 9.71[2.2 - 22.72]）、抗糖尿病药物（OR = 3.21[0.69 - 14.89]）、抗血小板和抗凝剂（OR = 6.44[1.45 - 28.64]）治疗相关。经过逻辑回归分析，仅年龄（OR = 1.11[1.05 - 1.16]）和高胆固醇血症（OR = 4.87[1.49 - 15.96]）与ED相关。
OSA患者中ED的患病率较高，主要见于重度OSA患者。影响OSA患者发生ED的因素主要是年龄和高胆固醇血症。其他可能相关的因素包括高血压、代谢控制不佳、缺血性心脏病以及使用抗高血压、降脂和抗糖尿病药物治疗。
