Endocr Pract. 2019 Jun;25(6):562-571. doi: 10.4158/EP-2018-0518. Epub 2019 Mar 13.
To investigate in vivo correlates of erectile dysfunction (ED) in male patients with acromegaly. Fifty-one male patients with acromegaly were assessed by the International Index of Erectile Function-5 and Acromegaly Quality of Life (Acro-QoL) questionnaires. The measurement of serum nitric oxide (NO) were performed in patients and age-matched nonacromegalic controls. Among 51 patients analyzed, 32 (62.7%) had ED. Patients with ED showed lower Acro-QoL scores regarding global (69.8 ± 17.7 versus 79.4 ± 11.2; = .035) and personal relationship dimensions (59.6 ± 22.1 versus 76.8 ± 17.6; = .012) than non-ED patients. ED patients were older (44.5 ± 11.2 years versus 33.2 ± 8.5 years; = .04) and showed higher growth hormone (GH) levels (15.5 μg/L [interquartile range of 9.5 to 34.5 μg/L] versus 5.9 μg/L [interquartile range of 3.4 to 13.9 μg/L]; = .001) compared to non-ED patients. The cutoff values for identifying ED were 7.9 μg/L for random GH and 5.3 μg/L for GH nadir after oral administration of 75 g of glucose. There was no significant difference in total testosterone levels between the two groups (6.36 ± 4.24 nmol/L versus 9.54 ± 5.50 nmol/L; = .299). The NO levels in patients with acromegaly were significantly lower than those in nonacromegalic controls (8.77 ± 1.78 μmol/L versus 19.19 ± 5.02 μmol/L, respectively; = .049). Furthermore, the NO levels were even lower in ED patients than those in non-ED patients (5.14 ± 0.98 μmol/L versus 12.09 ± 3.44 μmol/L; = .027). Our study showed that ED is prevalent in male acromegalic patients and may be associated with systemic endothelial dysfunction induced by excessive GH. Further studies investigating the mechanism of GH and ED are required. = Acromegaly Quality of Life; = erectile dysfunction; = follicle-stimulating hormone; = growth hormone; = insulin-like growth factor 1; = international index of erection function-5; = luteinizing hormone; = magnetic resonance imaging; = nitric oxide; = oral glucose tolerance test; = quality of life; = receiver operating characteristic.
探讨肢端肥大症男性患者勃起功能障碍（ED）的体内相关因素。
对 51 例肢端肥大症男性患者进行国际勃起功能指数-5（IIEF-5）和肢端肥大症生活质量问卷（Acro-QoL）评估。对患者和年龄匹配的非肢端肥大症对照组进行血清一氧化氮（NO）测量。
在分析的 51 例患者中，32 例（62.7%）存在 ED。ED 患者的 Acro-QoL 全球评分（69.8±17.7 与 79.4±11.2； =.035）和个人关系维度评分（59.6±22.1 与 76.8±17.6； =.012）均低于非 ED 患者。ED 患者年龄更大（44.5±11.2 岁与 33.2±8.5 岁； =.04），GH 水平更高（15.5μg/L[9.5-34.5μg/L 四分位间距]与 5.9μg/L[3.4-13.9μg/L 四分位间距]； =.001）。随机 GH 为 7.9μg/L，口服葡萄糖 75g 后 GH 谷值为 5.3μg/L，这两个值是 ED 的截断值。两组患者的总睾酮水平无显著差异（6.36±4.24nmol/L 与 9.54±5.50nmol/L； =.299）。肢端肥大症患者的 NO 水平明显低于非肢端肥大症对照组（8.77±1.78μmol/L 与 19.19±5.02μmol/L，分别； =.049）。此外，ED 患者的 NO 水平甚至低于非 ED 患者（5.14±0.98μmol/L 与 12.09±3.44μmol/L； =.027）。
ED 在肢端肥大症男性患者中较为普遍，可能与 GH 引起的全身血管内皮功能障碍有关。需要进一步研究 GH 和 ED 的作用机制。
