Department of Clinical and Molecular Medicine, University "Sapienza" of Rome, Sant'Andrea Hospital, Via di Grottarossa 1038, 00189, Rome, Italy.
GeneraLife IVF, Clinica Valle Giulia, via G. de Notaris 2b, Rome, Italy.
J Endocrinol Invest. 2022 Aug;45(8):1527-1534. doi: 10.1007/s40618-022-01788-5. Epub 2022 Apr 2.
The aim of this study was to evaluate in a population of patients with erectile dysfunction (ED): (a) the prevalence of a previously unknown endocrine/glycemic disorders; (b) the correlation between ED severity and endocrine/glycemic disorders.
1332 patients referred for ED from 2013 to 2020 were included. The ED diagnosis was made using the International-Erectile-Function-Index-5 questionnaire. ED severity was considered according to presence/absence of spontaneous erections, maintenance/achievement deficiency. All patients were subjected to search for sociodemographic and clinical characteristics: age, ethnicity, marital status, previous use of PDE5i, previous prostatectomy, diabetes mellitus (DM), prediabetes, endocrine dysfunctions.
The mean ± SD age was 54.3 ± 13.7 years. The 19.1% (255/1332) of patients were already in treatment for prediabetes/diabetes or endocrine dysfunctions. Among the remaining 1077, the prevalence of previously unknown endocrine and glycemic disorders was 30% (323/1077). Among them, 190/323 subjects (58.8%) were affected by hypogonadism, with high estradiol level observed in 8/190 (4.2%). The prevalence of new glycemic alterations was 17.3% (56/323) [specifically, 32/56 (57.1%) DM, and 24/56 (42.9%) prediabetes]. A thyroid dysfunction was observed in 40/323 subjects (12.3%) and hyperprolactinemia in 37/323 (11.5%). Patients with new diagnosis of DM showed more severe form of ED compared to the total group {difficulty in the achievement of erection: 46/56 [82.2%, vs 265/1332 (19.9%), p < 0.05]; absence of spontaneous erection 23/56 [41.1%, vs 321/1332 (24.1%), p < 0.05]}.
ED is an early marker of endocrine/glycemic disorder, and a previously unknown dysfunction was found in more than a quarter of patients. A newly diagnosed DM is associated with ED severity, especially in elderly man and in presence of hypertension.
本研究旨在评估勃起功能障碍（ED）患者人群中：（a）先前未知的内分泌/血糖紊乱的患病率；（b）ED 严重程度与内分泌/血糖紊乱之间的相关性。
纳入了 2013 年至 2020 年期间因 ED 就诊的 1332 名患者。使用国际勃起功能指数-5 问卷（International-Erectile-Function-Index-5）对 ED 进行诊断。根据自发性勃起的存在/不存在、维持/获得不足来考虑 ED 严重程度。所有患者均接受了社会人口统计学和临床特征的检查：年龄、种族、婚姻状况、先前使用 PDE5i、先前前列腺切除术、糖尿病（DM）、糖尿病前期、内分泌功能障碍。
平均年龄为 54.3±13.7 岁。19.1%（255/1332）的患者已经接受了糖尿病前期/糖尿病或内分泌功能障碍的治疗。在其余的 1077 名患者中，先前未知的内分泌和血糖紊乱的患病率为 30%（323/1077）。其中，190/323 名患者（58.8%）患有性腺功能减退症，8/190（4.2%）患者的雌二醇水平升高。新发血糖异常的患病率为 17.3%（56/323）[具体为 32/56（57.1%）DM，24/56（42.9%）糖尿病前期]。40/323 名患者（12.3%）患有甲状腺功能障碍，37/323 名患者（11.5%）患有高催乳素血症。与总人群相比，新诊断为 DM 的患者表现出更严重的 ED 形式{勃起困难：46/56 [82.2%，vs 1332/1332（19.9%），p<0.05]；无自发性勃起：23/56 [41.1%，vs 1332/1332（24.1%），p<0.05]}。
ED 是内分泌/血糖紊乱的早期标志物，超过四分之一的患者存在先前未知的功能障碍。新诊断的 DM 与 ED 的严重程度相关，尤其是在老年男性和高血压患者中。
