Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Pyeongchang Health Center & Country Hospital, Pyeongchang, Korea.
Korean J Intern Med. 2020 Sep;35(5):1245-1253. doi: 10.3904/kjim.2019.148. Epub 2020 Apr 21.
BACKGROUND/AIMS: Sarcopenia and erectile dysfunction (ED) are associated with poor health and quality of life in older men. We investigate the association between sarcopenia and severe ED in community-dwelling older men.
We prospectively assessed sarcopenia and ED in 519, community-dwelling, older men (mean age, 74.0) in Pyeongchang, Korea, in 2016 to 2017. Sarcopenia was based on muscle mass, grip strength, and gait speed according to the Asian Working Group consensus algorithm. Severe ED was defined as 5-item International Index of Erectile Function questionnaire score under 8. Logistic regressions were used to study associations between incident severe ED and sarcopenia, after adjusting age, cardiovascular risk factors, depression, and polypharmacy.
The prevalence of severe ED was 52.4% and that of sarcopenia was 31.6%. At baseline, the prevalence of severe ED was higher in men with sarcopenia than in those without (73.2% vs. 42.8%; adjusted odds ratio [aOR], 1.89; 95% confidence interval [CI], 1.18 to 3.03; p = 0.008). Slow gait speed (aOR, 2.80; 95% CI, 1.18 to 6.62; p = 0.019) and decreased muscle mass (aOR, 2.54; 95% CI, 1.11 to 5.81; p = 0.027) were associated with the incidence of severe ED, while decreased grip strength (aOR, 0.76; 95% CI, 0.30 to 1.91; p = 0.564) was not.
Sarcopenia was associated with severe ED. Slow gait speed, and decreased muscle mass was independently associated with incident severe ED at 1 year. Further research is warranted to examine whether an intervention targeting these components can prevent severe ED.
背景/目的：肌少症和勃起功能障碍（ED）与老年男性的健康状况和生活质量较差有关。我们调查了社区居住的老年男性中肌少症与严重 ED 之间的关系。
我们前瞻性评估了 2016 年至 2017 年在韩国平昌的 519 名社区居住的老年男性（平均年龄 74.0 岁）的肌少症和 ED。根据亚洲工作组共识算法，肌少症基于肌肉质量、握力和步速来确定。严重 ED 定义为 5 项国际勃起功能指数问卷评分低于 8 分。使用逻辑回归来研究肌少症与新发严重 ED 之间的关联，调整年龄、心血管危险因素、抑郁和多药治疗后。
严重 ED 的患病率为 52.4%，肌少症的患病率为 31.6%。在基线时，肌少症男性的严重 ED 患病率高于无肌少症男性（73.2% vs. 42.8%；调整后的优势比[aOR]，1.89；95%置信区间[CI]，1.18 至 3.03；p = 0.008）。缓慢的步速（aOR，2.80；95%CI，1.18 至 6.62；p = 0.019）和肌肉质量下降（aOR，2.54；95%CI，1.11 至 5.81；p = 0.027）与严重 ED 的发生相关，而握力下降（aOR，0.76；95%CI，0.30 至 1.91；p = 0.564）则不然。
肌少症与严重 ED 相关。缓慢的步速和肌肉质量下降与 1 年后新发严重 ED 独立相关。需要进一步研究以检查针对这些成分的干预措施是否可以预防严重 ED。
