The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
J Sex Med. 2024 Aug 1;21(8):716-722. doi: 10.1093/jsxmed/qdae069.
Peyronie's disease (PD) is a connective tissue disorder that affects the penis and is characterized by abnormal collagen structure in the penile tunica albuginea, resulting in plaque formation and penile deformity. PD's overall prevalence is estimated at 3.2% to 8.9%, with rates as high as 20.3% among men with type 2 diabetes mellitus (DM). However, the characteristics of DM associated with PD complications remain unclear.
To explore clinical associations between DM characteristics and PD complications.
We conducted a retrospective analysis of patients with DM and PD who presented at our institution between 2007 and 2022. We examined patients' clinical histories, DM- and PD-related clinical parameters, and complications. Penile deformities were assessed through physical examination, photographs, and penile Doppler ultrasound. Patients were categorized into subgroups based on age of DM onset: early (<45 years), average (45-65 years), and late (>65 years).
Outcomes included effects of DM characteristics on PD development, progression, and severity.
In total, 197 patients were included in the evaluation. Early-onset diabetes and elevated hemoglobin A1c (HbA1c) levels exhibited significant correlations with the early development of PD (ρ = 0.66, P < .001, and ρ = -0.24, P < .001, respectively). Furthermore, having DM at an early age was associated with the occurrence of penile plaque (ρ = -0.18, P = .03), and there were no significant differences in plaque dimensions (ρ = -0.29, P = .053). A rise in HbA1c levels after the initial PD diagnosis displayed positive correlations with the formation of penile plaque (ρ = 0.22, P < .006).
These findings emphasize the need for comprehensive assessments and personalized treatment strategies for individuals with DM and PD. Enhanced management approaches can improve outcomes for those facing both challenges.
Limitations include the single-site retrospective design with potential selection bias, inaccuracies in medical record data, and challenges in controlling confounding variables.
This study highlights that early-onset diabetes and poor diabetes control, as indicated by a subsequent rise in HbA1c levels following PD diagnosis, are significantly correlated with the onset and severity of PD. Revealing the mechanisms behind these findings will help us develop better management strategies for individuals with DM and PD.
佩罗尼氏病（PD）是一种影响阴茎的结缔组织疾病，其特征是阴茎白膜中的胶原结构异常，导致斑块形成和阴茎畸形。PD 的总体患病率估计为 3.2%至 8.9%，2 型糖尿病（DM）患者的患病率高达 20.3%。然而，与 PD 并发症相关的 DM 特征尚不清楚。
探讨 DM 特征与 PD 并发症之间的临床关联。
我们对 2007 年至 2022 年在我院就诊的 DM 和 PD 患者进行了回顾性分析。我们检查了患者的临床病史、DM 和 PD 相关的临床参数以及并发症。通过体格检查、照片和阴茎多普勒超声评估阴茎畸形。根据 DM 发病年龄将患者分为亚组：早发（<45 岁）、中发（45-65 岁）和晚发（>65 岁）。
共纳入 197 例患者进行评估。早发糖尿病和糖化血红蛋白（HbA1c）水平升高与 PD 的早期发展显著相关（ρ=0.66，P<0.001 和 ρ=-0.24，P<0.001）。此外，早发 DM 与阴茎斑块的发生有关（ρ=-0.18，P=0.03），但斑块大小无显著差异（ρ=-0.29，P=0.053）。PD 初始诊断后 HbA1c 水平升高与阴茎斑块形成呈正相关（ρ=0.22，P<0.006）。
这些发现强调了需要对 DM 和 PD 患者进行全面评估和个体化治疗策略。增强管理方法可以改善同时面临这两种挑战的患者的结局。
包括单中心回顾性设计，可能存在选择偏倚、病历数据不准确以及难以控制混杂变量等局限性。
本研究强调早发糖尿病和较差的糖尿病控制（表现为 PD 诊断后 HbA1c 水平升高）与 PD 的发病和严重程度显著相关。揭示这些发现背后的机制将有助于我们为 DM 和 PD 患者制定更好的管理策略。
