Yuan Chi, Jian Zhongyu, Gao Xiaoshuai, Jin Xi, Wang Menghua, Xiang Liyuan, Li Hong, Wang Kunjie
Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, P.R. China.
West China Biomedical Big Data Center, Sichuan University, Chengdu, P.R. China.
Andrology. 2022 Mar;10(3):518-524. doi: 10.1111/andr.13132. Epub 2021 Dec 14.
The causal effects of individual risk factors of metabolic syndrome on erectile dysfunction (ED) are still unclear.
To evaluate the causal effect of risk factors of metabolic syndrome on ED through Mendelian randomization (MR).
Data for risk factors were obtained from multiple databases with 173,082-757,601 individuals, and that for ED were collected from a genome-wide association study including 223,805 Europeans. We performed univariate MR analysis using inverse-variance weighted, MR-Egger, weighted-median, weighted mode methods and multivariable MR analysis to evaluate the total and direct causal effects.
The univariable MR supported that type 2 diabetes mellitus (odds ratios [OR] = 1.14, 95% confidence intervals [CI]: 1.08-1.21, p < 0.001) and body mass index (BMI) (OR = 1.27, 95% CI: 1.12-1.44, p < 0.001) were associated with ED. After excluding the SNPs associated with BMI and other risk factors, the results of multivariable MR for T2D (OR = 1.15, 95% CI: 1.05-1.25, p = 0.001) remained consistent. However, the results of multivariable MR provided limited evidence for the causality between BMI and ED (OR = 1.06, 95% CI: 0.88-1.29, p = 0.532). For systolic blood pressure and lipid components (low-density lipoprotein, high-density lipoprotein and triglycerides), both univariable and multivariable MR failed to offer sufficient evidence to confirm their causal effect on ED.
T2D showed a direct causal effect on ED independent of obesity and dyslipidemia.
代谢综合征的个体风险因素对勃起功能障碍(ED)的因果效应仍不明确。
通过孟德尔随机化(MR)评估代谢综合征风险因素对ED的因果效应。
风险因素数据来自多个数据库,涉及173,082 - 757,601名个体,ED数据收集自一项包含223,805名欧洲人的全基因组关联研究。我们使用逆方差加权、MR-Egger、加权中位数、加权模式方法进行单变量MR分析,并进行多变量MR分析以评估总体和直接因果效应。
单变量MR支持2型糖尿病(比值比[OR]=1.14,95%置信区间[CI]:1.08 - 1.21,p<0.001)和体重指数(BMI)(OR = 1.27,95% CI:1.12 - 1.44,p<0.001)与ED相关。在排除与BMI和其他风险因素相关的单核苷酸多态性后,2型糖尿病的多变量MR结果(OR = 1.15,95% CI:1.05 - 1.25,p = 0.001)保持一致。然而,多变量MR结果为BMI与ED之间的因果关系提供的证据有限(OR = 1.06,95% CI:0.88 - 1.29,p = 0.532)。对于收缩压和脂质成分(低密度脂蛋白、高密度脂蛋白和甘油三酯),单变量和多变量MR均未能提供足够证据证实它们对ED的因果效应。
2型糖尿病对ED显示出独立于肥胖和血脂异常的直接因果效应。