Moura Adriana, Tomada Inês, Tomada Nuno
Faculty of Medicine of Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.
Faculty of Biotechnology of Portuguese Catholic University and CBQF/Centro de Biotecnologia e Química Fina, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Arquiteto Lobão Vital, Porto, Portugal.
Turk J Urol. 2018 Nov;44(6):455-461. doi: 10.5152/tud.2018.66281.
To determine the prevalence of erectile dysfunction (ED) in metabolically healthy obese (MHO) individuals, and to compare ED severity and hypogonadism prevalence in MHO, metabolically unhealthy obese (MUO) and metabolically healthy non-obese individuals.
ED patients (n=460) were evaluated by standardized protocol, that included clinical evaluation, abridged 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire survey, and Penile Duplex Doppler Ultrasound (PDDU) exam. Patients were classified as obese [body mass index (BMI) ≥30.0 kg/m] and non-obese (BMI <30.0 kg/m), and metabolic health status was defined by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. Statistical analysis was performed and statistical significance was considered at p-level <0.05.
The mean age of the subjects was 56.2±10.5 years. MHO was present in 40% of obese individuals (n=37). MUO had lower mean peak systolic velocity (mPSV) compared to MHO (28.1 cm/s vs. 36.9 cm/s; p=0.005), and IIEF-5 scores were also lower in MUO compared to MHO patients (10.2 vs. 13.1; p=0.018). No statistical differences in IIEF-5 score, mPSV and hypogonadism prevalence between MHO and metabolically healthy non-obese (MHNO) patients were observed.
Our results lead us to conclude that healthy metabolic profile protects obese individuals from severity of ED. The strong association between obesity and ED may be otherwise attributed to metabolic abnormalities present in the obese.
确定代谢健康的肥胖（MHO）个体中勃起功能障碍（ED）的患病率，并比较MHO、代谢不健康的肥胖（MUO）和代谢健康的非肥胖个体的ED严重程度和性腺功能减退患病率。
对460例ED患者采用标准化方案进行评估，包括临床评估、国际勃起功能指数（IIEF-5）问卷简版5项调查以及阴茎双功多普勒超声（PDDU）检查。患者分为肥胖组[体重指数（BMI）≥30.0 kg/m²]和非肥胖组（BMI<30.0 kg/m²），代谢健康状况根据美国国家胆固醇教育计划成人治疗小组第三次报告（NCEP ATPIII）标准定义。进行统计学分析，p值<0.05时认为具有统计学意义。
受试者的平均年龄为56.2±10.5岁。40%的肥胖个体（n=37）为MHO。与MHO相比，MUO的平均收缩期峰值流速（mPSV）较低（28.1 cm/s对36.9 cm/s；p=0.005），与MHO患者相比，MUO的IIEF-5评分也较低（10.2对13.1；p=0.018）。未观察到MHO与代谢健康的非肥胖（MHNO）患者在IIEF-5评分、mPSV和性腺功能减退患病率方面的统计学差异。
我们的结果使我们得出结论，健康的代谢状况可保护肥胖个体免受ED严重程度的影响。肥胖与ED之间的强关联可能另有原因，是肥胖中存在的代谢异常所致。
