Capogrosso Paolo, Montorsi Francesco, Salonia Andrea
aUniversità Vita-Salute San Raffaele bDivision of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
Curr Opin Urol. 2016 Mar;26(2):140-5. doi: 10.1097/MOU.0000000000000257.
This article summarizes current findings supporting the role of erectile dysfunction as a proxy of general health status, with a focus on the young population.
Erectile dysfunction has been historically associated to increased cardiovascular risk and mortality. Several studies supported the role of erectile dysfunction as a predictive factor of subsequent cardiovascular events, acquiring significant importance even in young men. Similarly, erectile dysfunction emerged as a potential marker for metabolic alterations including diabetes mellitus and metabolic syndrome, eventually presenting as the initial manifestation of a dysmetabolic condition in young patients. Moreover, current epidemiologic data demonstrated a significant association of erectile dysfunction with several conditions including vascular, respiratory, gastrointestinal disorders, and endocrine with chronic-sustained inflammation representing the common pathophysiological link between erectile dysfunction and comorbidities. Interestingly, longitudinal studies demonstrated a higher risk of overall mortality in patients complaining of erectile dysfunction, even irrespective of cardiovascular risk.
Erectile dysfunction does not represent an uncommon condition among young men. Considering the amount of data demonstrating a strong correlation between several life-risky comorbidities and erectile dysfunction, a careful and comprehensive general health assessment of patients complaining of erectile dysfunction should be carried out, regardless of patient's age. The identification of erectile dysfunction as an early sign of a major comorbidity would allow the implementation of therapeutic measures aimed at improving the overall health status and life expectancy across the entire aging process.
本文总结了目前支持勃起功能障碍作为整体健康状况指标作用的研究结果，重点关注年轻人群。
勃起功能障碍在历史上一直与心血管风险增加和死亡率上升相关。多项研究支持勃起功能障碍作为后续心血管事件预测因素的作用，甚至在年轻男性中也具有重要意义。同样，勃起功能障碍已成为包括糖尿病和代谢综合征在内的代谢改变的潜在标志物，最终在年轻患者中表现为代谢紊乱状况的初始表现。此外，当前的流行病学数据表明，勃起功能障碍与包括血管、呼吸、胃肠道疾病和内分泌疾病在内的多种疾病存在显著关联，慢性持续性炎症是勃起功能障碍与合并症之间的共同病理生理联系。有趣的是，纵向研究表明，即使不考虑心血管风险，抱怨勃起功能障碍的患者总体死亡风险也更高。
勃起功能障碍在年轻男性中并不罕见。鉴于大量数据表明多种危及生命的合并症与勃起功能障碍之间存在密切关联，无论患者年龄如何，都应对抱怨勃起功能障碍的患者进行仔细全面的整体健康评估。将勃起功能障碍识别为主要合并症的早期迹象，将有助于实施旨在改善整个衰老过程中整体健康状况和预期寿命的治疗措施。
