Med Princ Pract. 2018;27(1):73-79. doi: 10.1159/000484949. Epub 2017 Nov 5.
The aim of this study was to investigate the association between the severity of erectile dysfunction (ED), cardiovascular risk, and target organ damage (heart, renal, vascular) in men free of cardiovascular diseases (CVD).
ED was assessed using the International Index of Erectile Function (IIEF-5). The study included 182 men: 100 with ED (IIEF mean score ≤21) and 82 without ED (IIEF mean score >21). Ultrasound was used to evaluate carotid plaques and left ventricular mass, geometry, and diastolic function. Cardiovascular anamnesis, CVD risk factors, and anthropometric and biochemical parameters were obtained. The European Society of Cardiology-Systematic Coronary Risk Evaluation Score (ESC-SCORE) was used to calculate total patient cardiovascular risk. Continuous variables between groups were compared using the Student t test and Mann-Whitney U test, while categorical data were compared using the χ2 test. Multiple linear regression was used to test the association between the severity of ED and presence of target organ damage.
The following parameters were significantly higher in the ED group compared to the controls: family history of coronary heart disease (43.7 vs. 26.7%, p = 0.047), ESC-SCORE (2.27 ± 1.79 vs. 1.61 ± 1.13, p = 0.012), and waist circumference (109.28 ± 10.82 vs. 106.17 ± 10.07, p = 0.047). Impaired renal function (p = 0.081), albuminuria (p = 0.545), vascular damage (p = 0.602), and diastolic function (p = 0.724) were similar in both groups. However, left ventricular hypertrophy (LVH; odds ratio 2.231, 95% CI 1.069-4.655, p = 0.22) was more frequent in the ED group (29.9 vs. 16.0%). The multiple linear regression analysis revealed that LVH (β = 1.761, p = 0.002) and impaired renal function assessed using the estimated glomerular filtration rate (<60 mL/min/1.73 m2; β = 6.207, p = 0.0001) were the independent risk factors for severity of ED.
This study showed that LVH and impaired renal function are associated with ED severity.
本研究旨在探讨无心血管疾病（CVD）男性勃起功能障碍（ED）严重程度、心血管风险与靶器官损伤（心脏、肾脏、血管）之间的关系。
采用国际勃起功能指数（IIEF-5）评估 ED。研究纳入 182 名男性：100 名 ED 患者（IIEF 平均评分≤21）和 82 名非 ED 患者（IIEF 平均评分>21）。采用超声评估颈动脉斑块和左心室质量、几何形状和舒张功能。获取心血管病史、CVD 危险因素以及人体测量学和生化参数。采用欧洲心脏病学会-系统性冠状动脉风险评估评分（ESC-SCORE）计算患者总体心血管风险。组间连续变量采用学生 t 检验和曼-惠特尼 U 检验进行比较，分类数据采用卡方检验进行比较。采用多元线性回归检验 ED 严重程度与靶器官损伤之间的关联。
与对照组相比，ED 组以下参数显著升高：冠心病家族史（43.7% vs. 26.7%，p = 0.047）、ESC-SCORE（2.27 ± 1.79 vs. 1.61 ± 1.13，p = 0.012）和腰围（109.28 ± 10.82 vs. 106.17 ± 10.07，p = 0.047）。两组间肾功能不全（p = 0.081）、蛋白尿（p = 0.545）、血管损伤（p = 0.602）和舒张功能（p = 0.724）相似。然而，ED 组左心室肥厚（LVH；优势比 2.231，95%置信区间 1.069-4.655，p = 0.02）更为常见（29.9% vs. 16.0%）。多元线性回归分析显示，LVH（β = 1.761，p = 0.002）和估计肾小球滤过率（<60 mL/min/1.73 m2；β = 6.207，p = 0.0001）降低是 ED 严重程度的独立危险因素。
本研究表明，LVH 和肾功能不全与 ED 严重程度相关。
