Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
Department of Urology, The First People's Hospital of Changzhou, Changzhou, Jiangsu, China.
Front Endocrinol (Lausanne). 2023 Jul 24;14:1080188. doi: 10.3389/fendo.2023.1080188. eCollection 2023.
The present study is the first to explore the correlation between serum folic acid (FA) level and penile arterial peak systolic velocity (PSV) as measured via penile color Doppler ultrasonography (PDU), which directly reflects endothelial function in the penile artery.
A total of 244 consecutive erectile dysfunction (ED) patients and 72 healthy controls, recruited from the Andrology department and the Healthy Physical Examination Center of our hospital, respectively, from June 2020 to April 2022, were included in the study. Serum FA was measured in ED patients and healthy controls, and PDU examinations were conducted for all eligible ED patients. The Pearson method was used to evaluate the correlation between FA levels and PDU parameters in ED patients. A receiver operating characteristic (ROC) curve analysis was also performed to calculate the sensitivity and specificity of these parameters for prediction of arteriogenic ED.
After the PDU test, the average serum FA level among patients diagnosed with arteriogenic ED was 8.08 ± 2.64 ng/ml, lower than the average of 10.78 ± 2.87 ng/ml among healthy controls. There were no statistically significant inter-group differences on any basic parameters, including age, body mass index, fasting blood glucose, total cholesterol, and triglyceride. For further analysis, we divided the arteriogenic ED group into three subgroups by PSV range to compare serum FA levels among these subgroups. The mean FA levels in each of these groups were 5.97 ± 1.51ng/ml, and 8.21 ± 2.37ng/ml, and 10.55 ± 2.56ng/ml, while the corresponding PSV values were 15.75 ± 2.39cm/s, 23.53 ± 2.19cm/s, and 32.72 ± 1.64cm/s. Overall, a positive correlation between PSV and FA level was found among patients with arteriogenic ED (r=0.605, P<0.001). Furthermore, when FA level was used, with a cut-off value of 10.045 ng/ml, as a criterion to distinguish patients with arteriogenic ED from healthy controls, the area under the curve (AUC) was 0.772 (95% confidential interval: [0.696, 0.848]), for a sensitivity of 0.611 and specificity of 0.824.
Serum FA level is positively correlated with PSV in ED patients, and has the ability to distinguish patients with arteriogenic ED from healthy controls. Taking these findings together, FA deficiency should be regarded as an independent risk factor for arteriogenic ED.
本研究首次探讨了血清叶酸（FA）水平与阴茎彩色多普勒超声（PDU）测量的阴茎动脉收缩期峰值速度（PSV）之间的相关性，PSV 可直接反映阴茎动脉内皮功能。
2020 年 6 月至 2022 年 4 月，连续纳入 244 例勃起功能障碍（ED）患者和 72 例健康对照者，分别来自我院男科和健康体检中心。ED 患者检测血清 FA，所有符合条件的 ED 患者均行 PDU 检查。采用 Pearson 法评估 ED 患者 FA 水平与 PDU 参数的相关性。绘制受试者工作特征（ROC）曲线分析这些参数对预测动脉性 ED 的敏感性和特异性。
PDU 检查后，动脉性 ED 患者平均血清 FA 水平为 8.08±2.64ng/ml，低于健康对照组的平均水平 10.78±2.87ng/ml。两组在年龄、体重指数、空腹血糖、总胆固醇和甘油三酯等基本参数方面无统计学差异。进一步分析，我们按 PSV 范围将动脉性 ED 组分为三组，比较三组亚组的血清 FA 水平。每组的平均 FA 水平分别为 5.97±1.51ng/ml、8.21±2.37ng/ml 和 10.55±2.56ng/ml，相应的 PSV 值分别为 15.75±2.39cm/s、23.53±2.19cm/s 和 32.72±1.64cm/s。总体而言，动脉性 ED 患者 PSV 与 FA 水平呈正相关（r=0.605，P<0.001）。此外，当 FA 水平作为区分动脉性 ED 患者和健康对照组的标准，截断值为 10.045ng/ml 时，曲线下面积（AUC）为 0.772（95%可信区间：[0.696，0.848]），敏感性为 0.611，特异性为 0.824。
ED 患者血清 FA 水平与 PSV 呈正相关，能够区分动脉性 ED 患者和健康对照组。综合这些发现，FA 缺乏应被视为动脉性 ED 的独立危险因素。
