勃起功能障碍男性的血管年龄和实际年龄：一项纵向研究。

Vascular and Chronological Age in Men With Erectile Dysfunction: A Longitudinal Study.

作者信息

Rastrelli Giulia, Corona Giovanni, Mannucci Edoardo, Maggi Mario

机构信息

Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy.

Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy; Endocrinology Section, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy.

出版信息

J Sex Med. 2016 Feb;13(2):200-8. doi: 10.1016/j.jsxm.2015.11.014.

DOI:10.1016/j.jsxm.2015.11.014

PMID:26953832

Abstract

INTRODUCTION

Impaired penile color Doppler ultrasound predicts major adverse cardiovascular (CV) events (MACE), particularly in men at low-risk. However, penile color Doppler ultrasound is not recommended in routine clinical checkups.

AIM

To evaluate whether the difference between vascular and chronological age (Δage), as derived from the SCORE algorithm, is a predictor of MACE in subjects consulting for erectile dysfunction (ED) independently from other CV risk factors, including penile color Doppler ultrasound parameters.

METHODS

A consecutive series of 1687 male patients attending the Outpatient Clinic for ED for the first time was retrospectively studied. Among them, the SCORE was applicable in 49.9% (n = 841) men, of whom 87.9% (n = 739) were free from previous MACE and were analyzed.

MAIN OUTCOME MEASURES

Vascular age was derived from the SCORE algorithm and the Δage was considered. Information on MACE was obtained through the City of Florence Registry Office. MACE were identified using the International Classification of Diseases, and fatal and nonfatal MACE were coded as 410-414 (ischemic heart disease), 420-429 (other heart diseases), or 798-799 (sudden death from cardiac diseases), 430-434 or 436-438 (cerebrovascular disease), and 440 (peripheral arterial disease).

RESULTS

Δage was associated with incident MACE. When dividing the population according to the median age (56 years), family history of CV diseases, and the presence of metabolic syndrome, the association between Δage and MACE was maintained only in low-risk subjects, even after adjusting for confounders [HR = 1.09(1.03-1.16), 1.05(1.01-1.10) and 1.08(1.01-1.16) for younger men, without CV family history or metabolic syndrome, respectively, all P < .05], including penile color Doppler ultrasound parameters.

CONCLUSION

In subjects consulting for ED, Δage is associated with incident MACE, in particular in low-risk men. The prediction of MACE by Δage is independent from other risk factors including penile color Doppler ultrasound parameters, so it can be used as a costless and safe surrogate marker of penile vascular damage.

摘要

引言

阴茎彩色多普勒超声检查结果异常预示着主要不良心血管（CV）事件（MACE），尤其是在低风险男性中。然而，阴茎彩色多普勒超声检查不建议用于常规临床检查。

目的

评估根据SCORE算法得出的血管年龄与实际年龄之差（Δage）是否是勃起功能障碍（ED）患者MACE的预测指标，且独立于其他心血管危险因素，包括阴茎彩色多普勒超声参数。

方法

对首次到门诊ED就诊的1687例男性患者进行回顾性研究。其中，49.9%（n = 841）的男性适用SCORE，其中87.9%（n = 739）既往无MACE，对这部分患者进行分析。

主要观察指标

血管年龄根据SCORE算法得出，并考虑Δage。通过佛罗伦萨市登记处获取MACE信息。使用国际疾病分类确定MACE，致命和非致命MACE编码为410 - 414（缺血性心脏病）、420 - 429（其他心脏病）或798 - 799（心脏病猝死）、430 - 434或436 - 438（脑血管疾病）以及440（外周动脉疾病）。

结果

Δage与新发MACE相关。根据年龄中位数（56岁）、心血管疾病家族史和代谢综合征的存在情况对人群进行划分后，即使在调整混杂因素后，Δage与MACE之间的关联仅在低风险受试者中仍然存在[年龄较小、无心血管疾病家族史或代谢综合征的男性的HR分别为1.09(1.03 - 1.16)、1.05(1.01 - 1.10)和1.08(1.01 - 1.16)，所有P <.05]，包括阴茎彩色多普勒超声参数。