Department of Andrology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China.
The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, Henan, China.
Am J Mens Health. 2024 Sep-Oct;18(5):15579883241278065. doi: 10.1177/15579883241278065.
Erectile dysfunction (ED) is a common problem that seriously impacts men's quality of life and mental health. Earlier studies have indicated that homocysteine (HCY) levels might be linked to the risk of ED, although these studies are limited by small sample sizes and insufficient correction for confounding factors. This study uses data from the 2001-2004 National Health and Nutrition Examination Survey (NHANES) to evaluate the relationship between HCY levels and ED risk in U.S. adult males. The analysis involved using a weighted generalized linear model to assess main effects and restricted cubic splines (RCS) to explore nonlinear relationships. Results showed that the association between HCY and ED was not statistically significant after adjusting for covariates. However, interaction analyses between age and the HCY-ED relationship showed that as age increases, the impact of HCY on ED strengthens. Based on this, subgroup analysis by age was carried out, revealing that in people aged 50 and above, HCY levels were significantly positively correlated with ED, especially when HCY levels exceeded 9.22 μmol/L, significantly increasing the risk of ED. Sensitivity analysis further confirmed the robustness of these findings. This study indicates that controlling HCY levels, especially in middle-aged and older men, might help prevent and treat ED, providing a foundation for future preventive strategies.
勃起功能障碍（ED）是一种常见的问题，严重影响男性的生活质量和心理健康。早期的研究表明，同型半胱氨酸（HCY）水平可能与 ED 的风险有关，尽管这些研究受到样本量小和混杂因素校正不足的限制。本研究利用 2001-2004 年全国健康和营养调查（NHANES）的数据，评估了美国成年男性 HCY 水平与 ED 风险之间的关系。分析采用加权广义线性模型评估主要效应，并用限制三次样条（RCS）探索非线性关系。结果表明，调整协变量后，HCY 与 ED 之间的关联无统计学意义。然而，年龄与 HCY-ED 关系之间的交互分析表明，随着年龄的增长，HCY 对 ED 的影响增强。基于此，进行了年龄亚组分析，结果表明在 50 岁及以上的人群中，HCY 水平与 ED 呈显著正相关，特别是当 HCY 水平超过 9.22 μmol/L 时，ED 的风险显著增加。敏感性分析进一步证实了这些发现的稳健性。本研究表明，控制 HCY 水平，特别是在中年和老年男性中，可能有助于预防和治疗 ED，为未来的预防策略提供了基础。
