Dilixiati Diliyaer, Kadier Kaisaierjiang, Lu Jian-De, Xie Shiping, Azhati Baihetiya, Xilifu Reyihan, Rexiati Mulati
Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China.
Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China.
Sex Med. 2024 Feb 10;12(1):qfae002. doi: 10.1093/sexmed/qfae002. eCollection 2024 Feb.
Previous observational studies have found a potential link between prostate disease, particularly prostate cancer (PCa), and kidney disease, specifically chronic renal disease (CKD), in relation to erectile dysfunction (ED), yet the causal relationship between these factors remains uncertain.
The study sought to explore the potential causal association between prostate diseases, renal diseases, renal function, and risk of ED.
In this study, 5 analytical approaches were employed to explore the causal relationships between various prostate diseases (PCa and benign prostatic hyperplasia), renal diseases (CKD, immunoglobulin A nephropathy, membranous nephropathy, nephrotic syndrome, and kidney ureter calculi), as well as 8 renal function parameters, with regard to ED. All data pertaining to exposure and outcome factors were acquired from publicly accessible genome-wide association studies. The methods used encompassed inverse variance weighting, MR-Egger, weighted median, simple mode, and weighted mode residual sum and outlier techniques. The MR-Egger intercept test was utilized to assess pleiotropy, while Cochran's Q statistic was employed to measure heterogeneity.
We employed inverse variance weighting MR as the primary statistical method to assess the causal relationship between exposure factors and ED.
Genetically predicted PCa demonstrated a causal association with an elevated risk of ED (odds ratio, 1.125; 95% confidence interval, 1.066-1.186; .0001). However, no compelling evidence was found to support associations between genetically determined benign prostatic hyperplasia, CKD, immunoglobulin A nephropathy, membranous nephropathy, nephrotic syndrome, kidney ureter calculi, and the renal function parameters investigated, and the risk of ED.
The risk of ED is considerably amplified in patients diagnosed with PCa, thereby highlighting the importance of addressing ED as a significant concern for clinicians treating individuals with PCa.
This study's strength lies in validating the PCa-ED association using genetic analysis, while its limitation is the heterogeneity in study results.
The results of this study suggest a potential link between PCa and a higher risk of ED.
既往观察性研究发现，前列腺疾病，尤其是前列腺癌（PCa），与肾脏疾病，特别是慢性肾病（CKD），在勃起功能障碍（ED）方面存在潜在联系，但这些因素之间的因果关系仍不确定。
本研究旨在探讨前列腺疾病、肾脏疾病、肾功能与ED风险之间的潜在因果关联。
在本研究中，采用了5种分析方法来探讨各种前列腺疾病（PCa和良性前列腺增生）、肾脏疾病（CKD、免疫球蛋白A肾病、膜性肾病、肾病综合征和肾输尿管结石）以及8种肾功能参数与ED之间的因果关系。所有与暴露和结局因素相关的数据均来自可公开获取的全基因组关联研究。所使用的方法包括逆方差加权、MR-Egger、加权中位数、简单模式以及加权模式残差和异常值技术。MR-Egger截距检验用于评估多效性，而Cochran's Q统计量用于测量异质性。
我们采用逆方差加权MR作为主要统计方法来评估暴露因素与ED之间的因果关系。
基因预测的PCa显示出与ED风险升高存在因果关联（优势比，1.125；95%置信区间，1.066 - 1.186；P <.0001）。然而，未发现有力证据支持基因决定的良性前列腺增生、CKD、免疫球蛋白A肾病、膜性肾病、肾病综合征、肾输尿管结石以及所研究的肾功能参数与ED风险之间存在关联。
被诊断为PCa的患者发生ED的风险显著增加，从而凸显了将ED作为治疗PCa患者的临床医生的重要关注点来加以解决的重要性。
本研究的优点在于使用基因分析验证了PCa与ED的关联，而其局限性在于研究结果存在异质性。
本研究结果提示PCa与较高的ED风险之间存在潜在联系。
