Zheng Wenzhong, Chen Xiang, Huang Jingwen, Zhang Shengxiong, Chen Tao, Zhang Liu, Li Xianxin, Li Qingyun, Dai Jican
Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
Sex Med. 2020 Mar;8(1):36-44. doi: 10.1016/j.esxm.2019.11.001. Epub 2020 Jan 31.
Obstructive sleep apnea (OSA) has been linked with erectile dysfunction (ED), but the relatively independent polysomnography (PSG) outcomes of apnea and nocturnal hypoxia may not effectively assess the physiological impairment of OSA well.
To propose a new calculation method, the blood oxygen accumulation distribution area index (BOADAI), for evaluating the association between OSA and ED.
In this study, 502 male participants with suspected OSA were enrolled. Clinical questionnaire, physical measurements, and PSG outcomes were obtained by 2 respiratory physicians. ED was assessed by a urologist using the International Index of Erectile Function-5 (IIEF-5). Whole pulse oxygen saturation curves during the sleep time were compressed into a fixed scale image, and the distribution area of oxygen saturation curves was outlined. We then calculated the value of the outlined area and normalized it by total sleep time. The least absolute shrinkage and selection operator logistic regression model was used for selecting the optimal variable associated with ED and model construction. The clinical net benefit of the BOADAI and its related modules was estimated and compared by decision curve analysis.
ED and OSA were assessed using the IIEF-5, clinical questionnaire, physical measurements, and PSG outcomes.
The frequency of ED in patients with OSA was significantly greater than that in the no-OSA group. Meanwhile, the new BOADAI was negatively correlated with the IIEF-5 score (r = -0.2525, P = .0000). Moreover, the least absolute shrinkage and selection operator method retained BOADAI but not the other PSG parameters such as respiratory disorder index and lowest SaO2. Finally, logistic regression analysis revealed that older age, lips with cyanochroia, systemic hypertension, and BOADAI were independently associated with ED, and decision curve analysis indicated the clinical usefulness of the BOADAI module.
This study revealed novel evidence that OSA is a risk factor for ED. Meanwhile, the BOADAI could act as a potential clinical characteristic to evaluate ED in patients with OSA and to provide clinical treatment recommendations. Zheng W, Chen X, Huang J, et al. Blood Oxygen Accumulation Distribution Area Index Is Associated With Erectile Dysfunction in Patients With Sleep Apnea-Results From a Cross-sectional Study. Sex Med 2019; 8:36-44.
阻塞性睡眠呼吸暂停（OSA）与勃起功能障碍（ED）有关，但呼吸暂停和夜间低氧相对独立的多导睡眠图（PSG）结果可能无法有效评估OSA的生理损害。
提出一种新的计算方法，即血氧累积分布面积指数（BOADAI），用于评估OSA与ED之间的关联。
本研究纳入了502名疑似OSA的男性参与者。由2名呼吸内科医生获取临床问卷、体格测量和PSG结果。由一名泌尿科医生使用国际勃起功能指数-5（IIEF-5）评估ED。将睡眠时间内的全脉氧饱和度曲线压缩成固定比例图像，并勾勒出氧饱和度曲线的分布区域。然后计算勾勒区域的值，并按总睡眠时间进行归一化。使用最小绝对收缩和选择算子逻辑回归模型选择与ED相关的最佳变量并构建模型。通过决策曲线分析估计并比较BOADAI及其相关模块的临床净效益。
使用IIEF-5、临床问卷、体格测量和PSG结果评估ED和OSA。
OSA患者的ED发生率显著高于无OSA组。同时，新的BOADAI与IIEF-5评分呈负相关（r = -0.2525，P = .0000）。此外，最小绝对收缩和选择算子方法保留了BOADAI，但未保留其他PSG参数，如呼吸紊乱指数和最低血氧饱和度（SaO2）。最后，逻辑回归分析显示，年龄较大、嘴唇发绀、全身性高血压和BOADAI与ED独立相关，决策曲线分析表明BOADAI模块具有临床实用性。
本研究揭示了新的证据，即OSA是ED的一个危险因素。同时，BOADAI可作为评估OSA患者ED的潜在临床特征，并为临床治疗提供建议。郑W，陈X，黄J等。血氧累积分布面积指数与睡眠呼吸暂停患者勃起功能障碍的相关性——一项横断面研究的结果。性医学2019；8：36 - 44。
