Wu Fei, Mao Shanhua, Yu Tianfang, Jiang Haowen, Ding Qiang, Xu Gang
Department of Urology, Huashan Hospital, Fudan University, 12 Central Urumqi Rd, Shanghai, 200040, People's Republic of China.
Department of Clinical Medicine, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.
World J Urol. 2016 Jul;34(7):999-1007. doi: 10.1007/s00345-015-1723-0. Epub 2015 Nov 2.
Erectile dysfunction (ED) and cardiovascular disease (CVD) share a great number of common risk factors. There is growing evidence that aldosterone, an independent CVD risk factor, is associated with ED.
The purpose of this study was to determine the relationship between plasma aldosterone and erectile dysfunction.
This study recruited 287 participants, ranging from 18 to 84 years old; 217 were suffering from ED, diagnosed by the International Index of Erectile Function 5 (IIEF-5) scores. Based on IIEF-5 scores, patients were divided into one control group and three ED groups (mild ED; moderate ED; severe ED).
The differences in principal characteristics, blood routine, sexual hormone, adrenal hormone, thyroid hormone, renal function, liver function and blood lipid were compared between ED and control groups.
Our study demonstrated that the difference of mean plasma aldosterone levels between ED group and the control group was statistically significant (P < 0.05). Stepwise logistic regression analysis of all the possible factors support the role of aldosterone as an independent risk factor for ED (OR 1.011; 95 % CI 1.003-1.018; P = 0.004). Similar statistical methods were applied to the comparison between moderate to severe ED group and control to mild ED group (OR 1.017; 95 % CI 1.009-1.024; P < 0.001). ROC curve and the area under the curve (0.718; 95 % CI 0.643-0.794; P < 0.001) were performed to assess the diagnostic effect and to compare the severity of risk with the known independent risk factors, such as age and cholesterol (0.704; 95 % CI 0.631-0.778; P < 0.001). When using a 374 pg/mL cut-off value from Youden index, the OR of ED group versus controls is 3.106 (95 % CI 1.458-6.617), while the OR of moderate to severe ED versus control and mild ED is 5.480 (95 % CI 3.108-9.662).
We determined that elevated plasma aldosterone concentration is an independent risk factor for ED. Our findings also indicate that the aldosterone, a well-recognized contributor to vascular injury, might be a potential bond between ED and CVD.
勃起功能障碍(ED)与心血管疾病(CVD)有大量共同的危险因素。越来越多的证据表明,醛固酮作为一种独立的心血管疾病危险因素,与勃起功能障碍有关。
本研究的目的是确定血浆醛固酮与勃起功能障碍之间的关系。
本研究招募了287名年龄在18至84岁之间的参与者;其中217人患有勃起功能障碍,通过国际勃起功能指数5(IIEF-5)评分进行诊断。根据IIEF-5评分,患者被分为一个对照组和三个勃起功能障碍组(轻度勃起功能障碍;中度勃起功能障碍;重度勃起功能障碍)。
比较勃起功能障碍组和对照组在主要特征、血常规、性激素、肾上腺激素、甲状腺激素、肾功能、肝功能和血脂方面的差异。
我们的研究表明,勃起功能障碍组与对照组之间的平均血浆醛固酮水平差异具有统计学意义(P<0.05)。对所有可能因素进行逐步逻辑回归分析,支持醛固酮作为勃起功能障碍独立危险因素的作用(OR 1.011;95%CI 1.003 - 1.018;P = 0.004)。将类似的统计方法应用于中度至重度勃起功能障碍组与对照组至轻度勃起功能障碍组的比较(OR 1.017;95%CI 1.009 - 1.024;P<0.001)。绘制ROC曲线及曲线下面积(0.718;95%CI 0.643 - 0.794;P<0.001)以评估诊断效果,并与已知的独立危险因素如年龄和胆固醇(0.704;95%CI 0.631 - 0.778;P<0.001)比较风险严重程度。当使用约登指数得出的374 pg/mL临界值时,勃起功能障碍组与对照组的OR为3.106(95%CI 1.458 - 6.617),而中度至重度勃起功能障碍组与对照组及轻度勃起功能障碍组的OR为5.480(95%CI 3.108 - 9.662)。
我们确定血浆醛固酮浓度升高是勃起功能障碍的独立危险因素。我们的研究结果还表明,醛固酮作为血管损伤的一个公认因素,可能是勃起功能障碍与心血管疾病之间的潜在联系。