Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, Md.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Md.
Am J Med. 2021 Feb;134(2):282-284. doi: 10.1016/j.amjmed.2020.07.015. Epub 2020 Aug 14.
Peripheral neuropathy and erectile dysfunction are common conditions that have both been linked to cardiovascular disease and its risk factors, especially diabetes. The aim of this study was to assess the association of large-fiber peripheral neuropathy with erectile dysfunction in adult US males with and without diabetes.
We included all men aged ≥40 years from the 2001-2002 National Health and Nutrition Examination Survey (NHANES) with data on erectile dysfunction and peripheral neuropathy (n = 1213, including 206 men with diabetes). Erectile dysfunction was assessed by a single question during a self-paced, computer-assisted self-interview. Peripheral neuropathy was evaluated using standardized 10-g monofilament testing, which assesses lower extremity sensation. We used logistic regression to examine the association of peripheral neuropathy with erectile dysfunction overall and stratified by diabetes status, adjusting for demographic and cardiovascular risk factors.
The prevalence of peripheral neuropathy was 26.1% (51.2% in men with diabetes and 22.5% in men without diabetes). There was a significant independent association of peripheral neuropathy with erectile dysfunction overall (odds ratio [OR] 1.71, 95% confidence interval [CI], 1.20-2.43) and among US adult men without diabetes (OR 1.68; 95% CI, 1.11-2.56). The association in adults with diabetes was not statistically significant (OR 1.29; 95% CI, 0.39-4.26), possibly owing to limited power in this subgroup.
Our study suggests that decreased lower extremity sensation, even in the absence of diabetes, is common and a novel risk factor for erectile dysfunction.
周围神经病变和勃起功能障碍是常见病症,两者都与心血管疾病及其危险因素有关,尤其是糖尿病。本研究旨在评估成年美国男性中,无论是否患有糖尿病,大纤维周围神经病变与勃起功能障碍之间的关联。
我们纳入了 2001-2002 年全国健康和营养调查(NHANES)中所有年龄≥40 岁的男性,这些男性有勃起功能障碍和周围神经病变的数据(n=1213,包括 206 名糖尿病患者)。勃起功能障碍通过自我节奏、计算机辅助的自我访谈中的一个问题进行评估。周围神经病变通过标准化的 10 克单丝测试进行评估,该测试评估下肢感觉。我们使用逻辑回归来检查周围神经病变与勃起功能障碍之间的总体关联,并按糖尿病状况进行分层,调整人口统计学和心血管危险因素。
周围神经病变的患病率为 26.1%(糖尿病患者为 51.2%,非糖尿病患者为 22.5%)。周围神经病变与勃起功能障碍总体上存在显著的独立关联(比值比[OR] 1.71,95%置信区间[CI],1.20-2.43),并且在没有糖尿病的美国成年男性中也是如此(OR 1.68;95% CI,1.11-2.56)。在糖尿病患者中,这种关联没有统计学意义(OR 1.29;95% CI,0.39-4.26),可能是由于该亚组的效力有限。
我们的研究表明,下肢感觉下降,即使在没有糖尿病的情况下,也很常见,并且是勃起功能障碍的一个新的危险因素。