载脂蛋白 A、载脂蛋白 B 和载脂蛋白 A/A 载脂蛋白 B 对勃起功能障碍的提示作用。

The Suggestive Effect of Apo A, Apo B, and Apo A/Apo B on Erectile Dysfunction.

机构信息

Department of Urology, Xiangya Hospital, Central South University, Changsha, China.

Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China; Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

出版信息

J Sex Med. 2021 Mar;18(3):448-456. doi: 10.1016/j.jsxm.2020.12.004. Epub 2021 Jan 7.

DOI:10.1016/j.jsxm.2020.12.004

PMID:33423974

Abstract

BACKGROUND

Erectile dysfunction (ED) is closely related to coronary heart disease (CHD). Apolipoprotein (Apo) A1, Apo B, and Apo A/Apo B are known to be predictive factors for CHD. They are not yet a definite laboratory marker for the diagnosis of ED in cardiology. Therefore, we investigated the association between Apo A1, Apo B, and Apo A/Apo B, and ED.

AIM

To investigate the association between Apo A, Apo B, and Apo A/Apo B and the severity of ED.

METHODS

A total of 152 ED patients and 39 healthy control participants underwent a fasting blood draw to test for Apo A, Apo B, and Apo A/Apo B and a detailed laboratory examination. The International Erectile Function Index (IIEF-5) was used to determine the severity of ED. Receiver operating characteristic (ROC) curve analysis was performed to identify the cutoff values for Apo A, Apo B, and Apo A/Apo B. Each questionnaire was completed before any diagnosis was made or treatment performed.

OUTCOMES

Several lipid profile indicators (Apo A, Apo B, Apo A/Apo B, lipoprotein (a), free fatty acids, and total cholesterol) were studied, along with several questionnaires.

RESULTS

In our study, the number of patients with no ED, mild ED, mild-to-moderate ED, and moderate-to-severe ED were 39 (20.4%), 58 (30.4%), 36 (18.8%), and 58 (30.4%), respectively. Apo A and Apo A/Apo B were significantly reduced in patients with more severe ED (P = .037 and P < .001, respectively), while Apo B was significantly increased in patients with more severe ED (P = .002). According to the ROC curve, Apo A/Apo B had a medium diagnostic value for risk of ED with an AUC of 0.743 (95% CI: 0.68-0.80). For moderate-to-severe ED, 3 apolipoprotein indexes, including Apo B, Apo A, and Apo A/Apo B had medium diagnostic performance with AUCs of 0.759 (95% CI: 0.66-0.84), 0.703 (95% CI: 0.60-0.79), and 0.808 (95% CI: 0.72-0.88), respectively.

CLINICAL IMPLICATIONS

Our results can inform cardiologists in the assessment of ED in patients with CHD.

STRENGTHS AND LIMITATIONS

This study is the first to investigate the association between apolipoprotein and ED in China. The major limitations are that our sample size was too small to have matched controls without ED for different Apo levels.

CONCLUSION

Our results showed that Apo B, Apo A, and Apo A/Apo B can be used as markers to evaluate the risk of ED and that these proteins play an important role in the etiology of ED. Li X, Li D. The Suggestive Effect of Apo A, Apo B, and Apo A/Apo B on Erectile Dysfunction. J Sex Med 2021;18:448-456.

摘要

背景

勃起功能障碍（ED）与冠心病（CHD）密切相关。载脂蛋白（Apo）A1、Apo B 和 Apo A/Apo B 是已知的 CHD 预测因素。它们尚未成为心脏病学中 ED 诊断的明确实验室标志物。因此，我们研究了 Apo A1、Apo B 和 Apo A/Apo B 与 ED 的关系。

目的

研究 Apo A、Apo B 和 Apo A/Apo B 与 ED 严重程度的关系。

方法

共纳入 152 例 ED 患者和 39 例健康对照组，均进行空腹采血以检测 Apo A、Apo B 和 Apo A/Apo B，并进行详细的实验室检查。国际勃起功能指数（IIEF-5）用于确定 ED 的严重程度。进行接收者操作特征（ROC）曲线分析以确定 Apo A、Apo B 和 Apo A/Apo B 的截断值。在做出任何诊断或进行任何治疗之前，每位患者均完成了每个问卷。