胰岛素抵抗是痛风患者勃起功能障碍的独立预测因子。
Insulin resistance is an independent predictor of erectile dysfunction in patients with gout.
机构信息
Division of Rheumatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
出版信息
Korean J Intern Med. 2019 Jan;34(1):202-209. doi: 10.3904/kjim.2016.350. Epub 2017 Oct 12.
BACKGROUND/AIMS: Gout is associated with metabolic disorders that are important risk factors for cardiovascular disease and erectile dysfunction (ED). We aimed to identify independent predictors of ED in patients with gout.
METHODS
From August 2014 to August 2015, male outpatients who were being treated for gout in our rheumatology clinic and healthy males without any history of inflammatory disease (control group) were studied. ED was assessed in participants using the five-item version of the International Index of Erectile Function questionnaire. Insulin resistance (IR) was estimated using the homeostatic model assessment (HOMA-IR). Logistic regression analysis was performed to determine the effect of variables on ED risk in all of the study subjects and in patients with gout.
RESULTS
We analyzed 80 patients with gout and 70 healthy controls. The median age of patients with gout was 52 years and median disease duration was 120 months. Gout patients were more likely to have ED than controls (55.3% vs. 41.4%, p < 0.047). After adjustment for confounding factors, only HOMA-IR was significantly associated with ED (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.05 to 3.15). Gout patients with ED were more likely to be older (p < 0.001), have higher HOMA-IR (p = 0.048), and have lower glomerular filtration rate (p = 0.038) than those without ED. Multivariate logistic regression analysis showed that HOMAIR was an independent predictor for ED (OR, 1.62; 95% CI, 1.03 to 2.82) in gout patients.
CONCLUSION
IR is an independent predictor of ED in patients with gout.
背景/目的：痛风与代谢紊乱有关，代谢紊乱是心血管疾病和勃起功能障碍（ED）的重要危险因素。我们旨在确定痛风患者 ED 的独立预测因素。
方法
2014 年 8 月至 2015 年 8 月，我们在风湿病门诊治疗的男性痛风患者和无炎症性疾病史的健康男性（对照组）参加了这项研究。使用国际勃起功能指数问卷的五分量表评估参与者的 ED。使用稳态模型评估（HOMA-IR）估计胰岛素抵抗（IR）。对所有研究对象和痛风患者进行逻辑回归分析，以确定变量对 ED 风险的影响。
结果
我们分析了 80 名痛风患者和 70 名健康对照者。痛风患者的中位年龄为 52 岁，中位病程为 120 个月。痛风患者发生 ED 的可能性高于对照组（55.3% vs. 41.4%，p < 0.047）。调整混杂因素后，只有 HOMA-IR 与 ED 显著相关（优势比 [OR]，1.82；95%置信区间 [CI]，1.05 至 3.15）。患有 ED 的痛风患者比没有 ED 的患者年龄更大（p < 0.001），HOMA-IR 更高（p = 0.048），肾小球滤过率更低（p = 0.038）。多变量逻辑回归分析显示，HOMA-IR 是痛风患者 ED 的独立预测因素（OR，1.62；95%CI，1.03 至 2.82）。
结论
IR 是痛风患者 ED 的独立预测因素。
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