Department of Urology, Hatem Private Hospital, Gaziantep 34010, Turkey.
Department of Urology, Faculty of Medicine, Istinye University, Istanbul 34010, Turkey.
J Sex Med. 2023 Apr 27;20(5):591-596. doi: 10.1093/jsxmed/qdad037.
Systemic inflammation and oxidative stress increase the possibility of erectile dysfunction (ED) through a coordinated response to vascular endothelial damage.
The study aimed to evaluate the status of oxidative stress and systemic inflammation in ED.
The analysis was a prospective, cross-sectional, single-center study. The study included non-ED (n = 54) and ED (n = 104) groups. The study analyzed demographics, clinical outputs, oxidative stress (total antioxidant status [TAS], total oxidant status [TOS], oxidative stress index [OSI]), and an inflammatory condition (multi-inflammatory index 1 [MII-1], MII-2).
Oxidative stress and systemic inflammation were evaluated together in ED, which was evaluated with the help of the International Erectile Function Index (IIEF) scale.
TAS significantly decreased in the ED group compared with the non-ED group (2.25 ± 0.83 mmol Trolox equivalents/L vs 1.45 ± 0.65 mmol Trolox equivalents/L; P = .001). TOS increased in the ED group (14.1 ± 6.2 μmol H2O2 equivalents/L) compared with non-ED group (11.05 ± 6.8 μmol H2O2 equivalents/L) (P = .002). OSI was as low as 0.74 ± 0.33 in the non-ED group and as high as 2.38 ± 0.85 in the ED group (P = .001). Both MII-1 (273 ± 398 vs 745 ± 1311; P = .012) and MII-2 (4.66 ± 5.02 vs 19.7 ± 29.4; P = .031) increased in the ED group compared with the non-ED group. IIEF was negatively correlated with MII-1 (r = -0.298; P = .009), MII-2 (r = -0.341; P = .006), and OSI (r = -0.387; P < .0001), while TAS had a strong positive correlation with the IIEF (r = 0.549; P = .0001). OSI was correlated with MII-1 (r = 0.304; P = .001) and MII-2 (r = 0.334; P = .001). OSI was the strongest parameter in predicting ED (P = .0001; area under the curve, 0.795; 95% confidence interval, 0.696-0.855). The cutoff was 0.71 at 80.5% sensitivity and 67.2% specificity.
OSI showed diagnostic potential for ED as an oxidative stress indicator, while MII-1 and MII-2 showed the effectiveness.
MIIs, a novel indicator of systemic inflammatory condition, were analyzed for the first time in patients with ED. The long-term diagnostic efficacy of these indices was lacking, as all patient data did not include long-term follow-up.
Considering their low cost and easy applicability compared with OSI, MIIs could be essential parameters in the follow-up for ED for physicians.
系统性炎症和氧化应激通过对血管内皮损伤的协同反应，增加了勃起功能障碍（ED）的可能性。
评估 ED 患者氧化应激和全身炎症的状况。
本分析为前瞻性、横断面、单中心研究。研究包括非 ED（n=54）和 ED（n=104）组。研究分析了人口统计学、临床结果、氧化应激（总抗氧化状态[TAS]、总氧化状态[TOS]、氧化应激指数[OSI]）和炎症情况（多炎症指标 1 [MII-1]、MII-2）。
ED 组的 TAS 明显低于非 ED 组（2.25±0.83mmol Trolox 当量/L 与 1.45±0.65mmol Trolox 当量/L；P=0.001）。ED 组的 TOS 升高（14.1±6.2μmol H2O2 当量/L），而非 ED 组为 11.05±6.8μmol H2O2 当量/L（P=0.002）。OSI 在非 ED 组低至 0.74±0.33，在 ED 组高至 2.38±0.85（P=0.001）。与非 ED 组相比，ED 组的 MII-1（273±398 与 745±1311；P=0.012）和 MII-2（4.66±5.02 与 19.7±29.4；P=0.031）均升高。IIEF 与 MII-1（r=-0.298；P=0.009）、MII-2（r=-0.341；P=0.006）和 OSI（r=-0.387；P<0.0001）呈负相关，而 TAS 与 IIEF 呈强正相关（r=0.549；P=0.0001）。OSI 与 MII-1（r=0.304；P=0.001）和 MII-2（r=0.334；P=0.001）相关。OSI 是预测 ED 的最强参数（P=0.0001；曲线下面积，0.795；95%置信区间，0.696-0.855）。截断值为 0.71，灵敏度为 80.5%，特异性为 67.2%。
OSI 作为氧化应激指标，对 ED 具有诊断潜力，而 MII-1 和 MII-2 则显示出有效性。
MIIs 作为一种新的全身炎症状态指标，首次在 ED 患者中进行了分析。由于所有患者的数据均不包括长期随访，因此这些指标的长期诊断效果仍存在不足。
考虑到其与 OSI 相比具有成本低、适用性强的特点，MIIs 可能是医生在 ED 随访中重要的参数。
