Corona D G, Vena W, Pizzocaro A, Rastrelli G, Sparano C, Sforza A, Vignozzi L, Maggi M
Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy.
Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy.
J Endocrinol Invest. 2023 Nov;46(11):2195-2211. doi: 10.1007/s40618-023-02136-x. Epub 2023 Jul 29.
The clinical significance of metabolic syndrome (MetS) versus its single components in erectile dysfunction (ED) is conflicting. Thus, the purpose is to analyze the available evidence on the relationship between MetS-along with its components-and ED.
All prospective and retrospective observational studies reporting information on ED and MetS were included. In addition, we here reanalyzed preclinical and clinical data obtained from a previously published animal model of MetS and from a consecutive series of more than 2697 men (mean age: 52.7 ± 12), respectively.
Data derived from this meta-analysis showed that MetS was associated with an up to fourfold increased risk of ED when either unadjusted or adjusted data were considered. Meta-regression analysis, performed using unadjusted statistics, showed that the MetS-related risk of ED was closely associated with all the MetS components. These associations were confirmed when unadjusted analyses from clinical models were considered. However, fully adjusted data showed that MetS-associated ED was more often due to morbidities included (or not) in the algorithm than to the MetS diagnostic category itself. MetS is also associated with low testosterone, but its contribution to MetS-associated ED-as derived from preclinical and clinical models-although independent, is marginal.
The results of our analysis suggest that MetS is a useless diagnostic category for studying ED. However, treating the individual MetS components is important, because they play a pivotal role in determining ED.
代谢综合征（MetS）及其单一组成成分在勃起功能障碍（ED）中的临床意义存在争议。因此，目的是分析关于MetS及其组成成分与ED之间关系的现有证据。
纳入所有报告ED和MetS相关信息的前瞻性和回顾性观察性研究。此外，我们在此分别重新分析了从先前发表的MetS动物模型以及连续的2697多名男性（平均年龄：52.7±12岁）中获得的临床前和临床数据。
该荟萃分析得出的数据表明，无论考虑未调整数据还是调整后的数据，MetS与ED风险增加高达四倍相关。使用未调整统计数据进行的荟萃回归分析表明，与MetS相关的ED风险与所有MetS组成成分密切相关。当考虑临床模型的未调整分析时，这些关联得到了证实。然而，完全调整后的数据表明，与MetS相关的ED更多是由于算法中包含（或未包含）的疾病，而非MetS诊断类别本身。MetS还与低睾酮有关，但其对MetS相关ED的贡献——源自临床前和临床模型——虽然独立，但作用微小。
我们的分析结果表明，MetS对于研究ED是一个无用的诊断类别。然而，治疗MetS的各个组成成分很重要，因为它们在决定ED方面起着关键作用。
