Du Xing-Li, Liu Lei, Song Wen, Zhou Xiang, Lv Zheng-Tao
Nursing Management Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
PLoS One. 2016 Dec 30;11(12):e0168784. doi: 10.1371/journal.pone.0168784. eCollection 2016.
The aim of this systematic review and meta-analysis was to assess the possible association between gout and erectile dysfunction (ED).
Studies were identified by extensively searching EMBASE, Pubmed, CENTRAL and ISI Web of Science. Four electronic databases were searched from their inception date to the latest issue (March 2016), without language restriction. Each reviewer screened articles independently and was blinded to the findings of the other reviewer. Data was extracted in adherence to the predetermined data collection form and meta-analysis was conducted via RevMan 5.3.
Five studies involving 56465 patients (mean age: 49.11 years) with gout and 155636 non-gout subjects (mean age: 48.76 years) were selected. The combination of unadjusted odds ratio (OR) showed that patients with gout were 1.44 times more likely to be diagnosed with ED when compared with control (95% confidence interval (95%CI) 1.20, 1.72). After adjustment for age and comorbidities, the heightened risk to develop ED was still present (1.18, 95%CI 1.02, 1.38). Subgroup-analysis by age showed statistically significant association of gout and ED in all age groups. However, evidence supporting a causal effect of gout on ED was insufficient.
The findings of this review indicated a positive association of gout and ED, but this work is hampered by the heterogeneity among included studies, to some extent. Future studies with larger community-based homogeneous population and randomized controlled trials aimed to evaluate the effect of gout treatment on ED associated outcomes are needed at this point.
本系统评价和荟萃分析的目的是评估痛风与勃起功能障碍（ED）之间可能存在的关联。
通过广泛检索EMBASE、Pubmed、CENTRAL和ISI Web of Science来识别研究。检索了四个电子数据库从其创建日期到最新一期（2016年3月）的文献，无语言限制。每位审阅者独立筛选文章，且对另一位审阅者的结果不知情。按照预先确定的数据收集表提取数据，并通过RevMan 5.3进行荟萃分析。
选择了五项研究，涉及56465例痛风患者（平均年龄：49.11岁）和155636例非痛风受试者（平均年龄：48.76岁）。未调整的优势比（OR）合并结果显示，与对照组相比，痛风患者被诊断为ED的可能性高1.44倍（95%置信区间（95%CI）1.20，1.72）。在调整年龄和合并症后，发生ED的风险仍然升高（1.18，95%CI 1.02，1.38）。按年龄进行的亚组分析显示，痛风与ED在所有年龄组中均存在统计学上的显著关联。然而，支持痛风对ED有因果作用的证据不足。
本综述的结果表明痛风与ED之间存在正相关，但在一定程度上，这项工作受到纳入研究之间异质性的阻碍。此时需要开展以社区为基础的更大规模同质人群的未来研究以及旨在评估痛风治疗对ED相关结局影响的随机对照试验。
